Provider Demographics
NPI:1801213319
Name:KRYCZKA, ANETA KAROLINA (LCPC)
Entity Type:Individual
Prefix:
First Name:ANETA
Middle Name:KAROLINA
Last Name:KRYCZKA
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 1:424 FORT HILL DR STE 104
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-3909
Mailing Address - Country:US
Mailing Address - Phone:630-315-0021
Mailing Address - Fax:
Practice Address - Street 1:424 FORT HILL DR STE 104
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-3909
Practice Address - Country:US
Practice Address - Phone:630-315-0021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-21
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178008537101YM0800X
IL180009225101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health