Provider Demographics
NPI:1891858973
Name:MAUL, MARILYN KAY (LMFT LCPC)
Entity Type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:KAY
Last Name:MAUL
Suffix:
Gender:F
Credentials:LMFT LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 W 22ND ST
Mailing Address - Street 2:STE 120
Mailing Address - City:OAKBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523
Mailing Address - Country:US
Mailing Address - Phone:630-572-1535
Mailing Address - Fax:630-572-9974
Practice Address - Street 1:210 W 22ND ST
Practice Address - Street 2:STE 120
Practice Address - City:OAKBROOK
Practice Address - State:IL
Practice Address - Zip Code:60523
Practice Address - Country:US
Practice Address - Phone:630-572-1535
Practice Address - Fax:630-572-9974
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional