Provider Demographics
NPI:1972098408
Name:KULIK, GREGORY JAMES (LCPC, CADC)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:JAMES
Last Name:KULIK
Suffix:
Gender:M
Credentials:LCPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 THOMPSON AVE
Mailing Address - Street 2:
Mailing Address - City:WINTHROP HARBOR
Mailing Address - State:IL
Mailing Address - Zip Code:60096-1152
Mailing Address - Country:US
Mailing Address - Phone:872-203-3640
Mailing Address - Fax:
Practice Address - Street 1:132 THOMPSON AVE
Practice Address - Street 2:
Practice Address - City:WINTHROP HARBOR
Practice Address - State:IL
Practice Address - Zip Code:60096-1152
Practice Address - Country:US
Practice Address - Phone:872-203-3640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-27
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.013464101YM0800X
IL178.014018101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)