Provider Demographics
NPI:1295032381
Name:LENGFELDER, BRIAN GENE (LCPC, CAADC, SAP)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:GENE
Last Name:LENGFELDER
Suffix:
Gender:M
Credentials:LCPC, CAADC, SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 GOLFVIEW DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60139-3675
Mailing Address - Country:US
Mailing Address - Phone:307-407-5356
Mailing Address - Fax:630-480-2913
Practice Address - Street 1:800 ROOSEVELT RD STE 322
Practice Address - Street 2:
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137
Practice Address - Country:US
Practice Address - Phone:630-740-7535
Practice Address - Fax:630-480-2913
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-25
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180006936101YA0400X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health