Provider Demographics
NPI:1770025645
Name:WEITZEL, MONICA (LCSW, CADC)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:WEITZEL
Suffix:
Gender:F
Credentials:LCSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 FOX GLEN CT
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-1834
Mailing Address - Country:US
Mailing Address - Phone:847-842-7200
Mailing Address - Fax:847-842-7454
Practice Address - Street 1:600 FOX GLEN CT
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-1834
Practice Address - Country:US
Practice Address - Phone:847-842-7200
Practice Address - Fax:847-842-7454
Is Sole Proprietor?:No
Enumeration Date:2016-11-09
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL23119101YA0400X
IL1490088361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)