Provider Demographics
NPI:1851077044
Name:FROGOZO, CAROLINE (MA, LPC)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:FROGOZO
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 W WASHINGTON ST APT 3901
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-3525
Mailing Address - Country:US
Mailing Address - Phone:915-258-9473
Mailing Address - Fax:
Practice Address - Street 1:118 N CLINTON ST STE 440
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60661-2392
Practice Address - Country:US
Practice Address - Phone:915-258-9473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178019123101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional