Provider Demographics
NPI:1689174971
Name:PASIEKA, SCOTT (LPC)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:PASIEKA
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 W VAN BUREN ST UNIT 3109
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-3939
Mailing Address - Country:US
Mailing Address - Phone:708-997-0194
Mailing Address - Fax:
Practice Address - Street 1:235 W VAN BUREN ST UNIT 3109
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-3939
Practice Address - Country:US
Practice Address - Phone:170-899-7019
Practice Address - Fax:708-997-0194
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-13
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.013441103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist