Provider Demographics
NPI:1255980991
Name:FIGUEROA, GUILLERMINA (LCP)
Entity type:Individual
Prefix:
First Name:GUILLERMINA
Middle Name:
Last Name:FIGUEROA
Suffix:
Gender:F
Credentials:LCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31979 N FISH LAKE RD
Mailing Address - Street 2:
Mailing Address - City:ROUND LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60073-9517
Mailing Address - Country:US
Mailing Address - Phone:847-201-7066
Mailing Address - Fax:
Practice Address - Street 1:31979 N FISH LAKE RD
Practice Address - Street 2:
Practice Address - City:ROUND LAKE
Practice Address - State:IL
Practice Address - Zip Code:60073-9517
Practice Address - Country:US
Practice Address - Phone:847-546-6450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL17811916101YP2500X
IL178011916101YA0400X
IL178.011916101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health