Provider Demographics
NPI:1558865741
Name:VENTUCCI, DOMINIKA (LCSW)
Entity type:Individual
Prefix:
First Name:DOMINIKA
Middle Name:
Last Name:VENTUCCI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DOMINIKA
Other - Middle Name:
Other - Last Name:BIELINSKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:703 LLOYD LN
Mailing Address - Street 2:
Mailing Address - City:NORTH AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60542-9088
Mailing Address - Country:US
Mailing Address - Phone:773-816-9804
Mailing Address - Fax:
Practice Address - Street 1:703 LLOYD LN
Practice Address - Street 2:
Practice Address - City:NORTH AURORA
Practice Address - State:IL
Practice Address - Zip Code:60542-9088
Practice Address - Country:US
Practice Address - Phone:773-816-9804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-21
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0197331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical