Provider Demographics
NPI:1821458357
Name:FROELICH, JENNA (LCPC)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:FROELICH
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 1:103 N 11TH AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-2289
Mailing Address - Country:US
Mailing Address - Phone:630-296-4169
Mailing Address - Fax:
Practice Address - Street 1:103 N 11TH AVE STE 105
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-2289
Practice Address - Country:US
Practice Address - Phone:630-296-4169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-25
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.010783101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional