Provider Demographics
NPI:1871034447
Name:MICHELLE DELAROSA THERAPY, LCPC, LLC
Entity Type:Organization
Organization Name:MICHELLE DELAROSA THERAPY, LCPC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:DELAROSA
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:847-302-1196
Mailing Address - Street 1:800 E NORTHWEST HWY
Mailing Address - Street 2:SUITE 422
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60074-6519
Mailing Address - Country:US
Mailing Address - Phone:847-302-1196
Mailing Address - Fax:847-485-7142
Practice Address - Street 1:800 E NORTHWEST HWY
Practice Address - Street 2:SUITE 422
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60074-6519
Practice Address - Country:US
Practice Address - Phone:847-302-1196
Practice Address - Fax:847-485-7142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-16
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180003905101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty