Provider Demographics
NPI:1811413933
Name:SCOLARO, ALLISON (LCPC)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:SCOLARO
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 1:1717 N NAPER BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8838
Mailing Address - Country:US
Mailing Address - Phone:667-706-0555
Mailing Address - Fax:
Practice Address - Street 1:1717 N NAPER BLVD STE 200
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-8838
Practice Address - Country:US
Practice Address - Phone:667-706-7055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-21
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
IL180.013157101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL180.013157OtherIDFPR
IL1639231731Medicaid