Provider Demographics
NPI:1912004086
Name:ULANOWSKI, DONNA LEE (MA LCPC)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:LEE
Last Name:ULANOWSKI
Suffix:
Gender:F
Credentials:MA LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5758 TIMBERLAKE WEST
Mailing Address - Street 2:
Mailing Address - City:MONEE
Mailing Address - State:IL
Mailing Address - Zip Code:60449
Mailing Address - Country:US
Mailing Address - Phone:708-534-8699
Mailing Address - Fax:708-534-8639
Practice Address - Street 1:3612 W LINCOLN HIGHWAY
Practice Address - Street 2:SUITE 17 PERSONAL GROWTH CENTER
Practice Address - City:OLYMPIA FIELDS
Practice Address - State:IL
Practice Address - Zip Code:60461
Practice Address - Country:US
Practice Address - Phone:708-503-9400
Practice Address - Fax:708-534-8639
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
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
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01632691OtherBLUE CROSS BLUE SHIELD