Provider Demographics
NPI:1902395544
Name:SLUTZKY, AMY (LCPC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:SLUTZKY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:KRICHMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:620 SYCAMORE LN
Mailing Address - Street 2:
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-3734
Mailing Address - Country:US
Mailing Address - Phone:847-226-6213
Mailing Address - Fax:
Practice Address - Street 1:200 N FAIRWAY DR STE 208
Practice Address - Street 2:
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1803
Practice Address - Country:US
Practice Address - Phone:847-996-6666
Practice Address - Fax:847-996-6665
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-09
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.005789101YP2500X, 101YM0800X
IL180.013802101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty