Provider Demographics
NPI:1851807945
Name:SACCO, BREANNA (LPC)
Entity Type:Individual
Prefix:
First Name:BREANNA
Middle Name:
Last Name:SACCO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:189 N CATALPA ST
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:IL
Mailing Address - Zip Code:60101-5244
Mailing Address - Country:US
Mailing Address - Phone:630-254-4232
Mailing Address - Fax:
Practice Address - Street 1:111 W JACKSON BLVD STE 17028
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60604-3589
Practice Address - Country:US
Practice Address - Phone:630-254-4232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-27
Last Update Date:2017-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.013546101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional