Provider Demographics
NPI:1255820460
Name:SALVADOR, BRITTANY (LCPC)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:SALVADOR
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 1:5120 WINONA LN
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-1806
Mailing Address - Country:US
Mailing Address - Phone:815-494-4852
Mailing Address - Fax:
Practice Address - Street 1:5120 WINONA LN
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-1806
Practice Address - Country:US
Practice Address - Phone:815-494-4852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-02
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180011541101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor