Provider Demographics
NPI:1740577626
Name:GIELCZYNSKI, TERESA MARZENA (MSW, LCSW, ICDVP)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:MARZENA
Last Name:GIELCZYNSKI
Suffix:
Gender:F
Credentials:MSW, LCSW, ICDVP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 E HIGGINS RD STE 104G
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4792
Mailing Address - Country:US
Mailing Address - Phone:847-338-5888
Mailing Address - Fax:
Practice Address - Street 1:830 E HIGGINS RD STE 104G
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173
Practice Address - Country:US
Practice Address - Phone:847-338-5888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-29
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0144761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical