Provider Demographics
NPI:1184972622
Name:ANGELAKOS, GEORGIA (LCPC)
Entity type:Individual
Prefix:
First Name:GEORGIA
Middle Name:
Last Name:ANGELAKOS
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 1:7902 N NEVA AVE
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-3212
Mailing Address - Country:US
Mailing Address - Phone:312-804-9649
Mailing Address - Fax:
Practice Address - Street 1:5406 W DEVON AVE RM 202A
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-4146
Practice Address - Country:US
Practice Address - Phone:312-804-9649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-15
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YM0800X
IL180.008329101YP2500X
IL180008329101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health