Provider Demographics
NPI:1821164716
Name:HERULA, DONNA LISA (MS, LCPC, LMFT, CADC)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:LISA
Last Name:HERULA
Suffix:
Gender:F
Credentials:MS, LCPC, LMFT, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 ROSE TER
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-1345
Mailing Address - Country:US
Mailing Address - Phone:847-269-4357
Mailing Address - Fax:847-726-8665
Practice Address - Street 1:135 N GREENLEAF ST
Practice Address - Street 2:SUITE 215
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-3393
Practice Address - Country:US
Practice Address - Phone:847-269-4357
Practice Address - Fax:847-726-8665
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL030654 (CEAP)101Y00000X
IL15147101YA0400X
IL101YP2500X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist