Provider Demographics
NPI:1023270303
Name:GARIBALDI, BRIAN (MA, LCPC)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:GARIBALDI
Suffix:
Gender:M
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3345 N ARLINGTON HEIGHTS RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-1591
Mailing Address - Country:US
Mailing Address - Phone:847-577-1501
Mailing Address - Fax:847-577-1501
Practice Address - Street 1:3345 N ARLINGTON HEIGHTS RD
Practice Address - Street 2:SUITE E
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-1591
Practice Address - Country:US
Practice Address - Phone:847-577-1501
Practice Address - Fax:847-577-3858
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
IL180.007638101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health