Provider Demographics
NPI:1912383407
Name:HOLICH, GREGORY B (LPC)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:B
Last Name:HOLICH
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5810 OAKWOOD DR
Mailing Address - Street 2:UNIT 1H
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-2974
Mailing Address - Country:US
Mailing Address - Phone:630-674-4734
Mailing Address - Fax:
Practice Address - Street 1:1800 RAVINIA PL
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-3761
Practice Address - Country:US
Practice Address - Phone:708-403-7570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-06
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.010484101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional