Provider Demographics
NPI:1740607589
Name:TORTORELLO, CASEY BURDEN (LCPC)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:BURDEN
Last Name:TORTORELLO
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 N LA SALLE ST STE 1850
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-1100
Mailing Address - Country:US
Mailing Address - Phone:847-207-5575
Mailing Address - Fax:
Practice Address - Street 1:134 N LA SALLE ST STE 1850
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-1100
Practice Address - Country:US
Practice Address - Phone:847-207-5575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-18
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178009186101YP2500X
IL180009816101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional