Provider Demographics
NPI:1356562987
Name:KLIBANOW, DENISE (LCPC)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:KLIBANOW
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 1:1 E NORTHWEST HWY STE 201
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-1700
Mailing Address - Country:US
Mailing Address - Phone:847-859-9529
Mailing Address - Fax:
Practice Address - Street 1:1 E NORTHWEST HWY STE 201
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-1700
Practice Address - Country:US
Practice Address - Phone:847-859-2987
Practice Address - Fax:773-257-5330
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180005651101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional