Provider Demographics
NPI:1972686830
Name:SCOLAN, DINA LYNN (LCPC)
Entity Type:Individual
Prefix:
First Name:DINA
Middle Name:LYNN
Last Name:SCOLAN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6567 BERRYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60516-3034
Mailing Address - Country:US
Mailing Address - Phone:630-222-1794
Mailing Address - Fax:
Practice Address - Street 1:5509 BELMONT RD
Practice Address - Street 2:SUITE 1E
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-4473
Practice Address - Country:US
Practice Address - Phone:630-222-1794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3477101YM0800X
NE1746101YP2500X
IL180.002298101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional