Provider Demographics
NPI:1992002299
Name:ZMOLEK, GWYN MARIE (MA, LCPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:GWYN
Middle Name:MARIE
Last Name:ZMOLEK
Suffix:
Gender:F
Credentials:MA, LCPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:547 ARBOR LN
Mailing Address - Street 2:
Mailing Address - City:SOUTH ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60177-2863
Mailing Address - Country:US
Mailing Address - Phone:630-476-1944
Mailing Address - Fax:855-975-2405
Practice Address - Street 1:547 ARBOR LN
Practice Address - Street 2:
Practice Address - City:SOUTH ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60177-2863
Practice Address - Country:US
Practice Address - Phone:630-476-1944
Practice Address - Fax:855-975-2405
Is Sole Proprietor?:No
Enumeration Date:2011-02-22
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.008496101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional