Provider Demographics
NPI:1952666372
Name:THERESE GIOLAS, MA, LCPC, LTD.
Entity Type:Organization
Organization Name:THERESE GIOLAS, MA, LCPC, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THERESE
Authorized Official - Middle Name:
Authorized Official - Last Name:GIOLAS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LCPC
Authorized Official - Phone:630-420-2596
Mailing Address - Street 1:445 JACKSON AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-5256
Mailing Address - Country:US
Mailing Address - Phone:630-420-2596
Mailing Address - Fax:630-420-2796
Practice Address - Street 1:445 JACKSON AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-5256
Practice Address - Country:US
Practice Address - Phone:630-420-2596
Practice Address - Fax:630-420-2796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.008072101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1740552132OtherINIDIVIDUAL NPI