Provider Demographics
NPI:1457703456
Name:PIEKARZ, LAUREN (LCPC, NCC, CCMHC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:PIEKARZ
Suffix:
Gender:F
Credentials:LCPC, NCC, CCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16575 OAK PARK AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-1799
Mailing Address - Country:US
Mailing Address - Phone:708-274-7131
Mailing Address - Fax:
Practice Address - Street 1:16571 OAK PARK AVE STE 220
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-1752
Practice Address - Country:US
Practice Address - Phone:708-274-7131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-01
Last Update Date:2021-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL20210223014306Medicaid
IL20200412026500Medicaid