Provider Demographics
NPI:1508337999
Name:CONGINE, FRANK MICHAEL (LCPC, LPC, CMHC)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:MICHAEL
Last Name:CONGINE
Suffix:
Gender:M
Credentials:LCPC, LPC, CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1139 23RD ST
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-2927
Mailing Address - Country:US
Mailing Address - Phone:312-735-3320
Mailing Address - Fax:
Practice Address - Street 1:70 W MADISON ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-4252
Practice Address - Country:US
Practice Address - Phone:312-735-3220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-10
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.009229101YP2500X
COLPC.0094986101YP2500X
UT11041667-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health