Provider Demographics
NPI:1912217209
Name:HOLMGREN, DENISE NETKO (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:NETKO
Last Name:HOLMGREN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:DENISE
Other - Middle Name:KATHERINE
Other - Last Name:NETKO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:2542 W NORTH AVE
Mailing Address - Street 2:COMMUNITY COUNSELING CENTER OF CHICAGO
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-5216
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2542 W NORTH AVE
Practice Address - Street 2:COMMUNITY COUNSELING CENTER OF CHICAGO
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-5216
Practice Address - Country:US
Practice Address - Phone:773-769-0205
Practice Address - Fax:773-365-3091
Is Sole Proprietor?:No
Enumeration Date:2010-10-20
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL166000800106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist