Provider Demographics
NPI:1760655955
Name:LUBCHENKO, DENNIS A (LCPC, CADC, PCGC)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:A
Last Name:LUBCHENKO
Suffix:
Gender:M
Credentials:LCPC, CADC, PCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 MILWAUKEE AVE
Mailing Address - Street 2:SUITE 235
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-3513
Mailing Address - Country:US
Mailing Address - Phone:847-436-6967
Mailing Address - Fax:847-787-5249
Practice Address - Street 1:1020 MILWAUKEE AVE
Practice Address - Street 2:SUITE 235
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-3513
Practice Address - Country:US
Practice Address - Phone:847-436-6967
Practice Address - Fax:847-787-5249
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-08
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health