Provider Demographics
NPI:1750039277
Name:SPARAGIS, CONSTANTINE G (LPC, BC-TMH)
Entity Type:Individual
Prefix:
First Name:CONSTANTINE
Middle Name:G
Last Name:SPARAGIS
Suffix:
Gender:M
Credentials:LPC, BC-TMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26063 W LESLIE DR
Mailing Address - Street 2:
Mailing Address - City:CHANNAHON
Mailing Address - State:IL
Mailing Address - Zip Code:60410-5353
Mailing Address - Country:US
Mailing Address - Phone:815-600-5278
Mailing Address - Fax:
Practice Address - Street 1:26063 W LESLIE DR
Practice Address - Street 2:
Practice Address - City:CHANNAHON
Practice Address - State:IL
Practice Address - Zip Code:60410-5353
Practice Address - Country:US
Practice Address - Phone:815-600-5278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.01958101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health