Provider Demographics
NPI:1700490810
Name:WOJCIECHOWSKI, BETSY ANN (LCPC)
Entity Type:Individual
Prefix:MS
First Name:BETSY
Middle Name:ANN
Last Name:WOJCIECHOWSKI
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:BETSY
Other - Middle Name:ANN
Other - Last Name:HANLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2475 FAIRFAX WAY
Mailing Address - Street 2:
Mailing Address - City:YORKVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60560-8009
Mailing Address - Country:US
Mailing Address - Phone:815-302-9677
Mailing Address - Fax:
Practice Address - Street 1:1431 OPUS PL
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1166
Practice Address - Country:US
Practice Address - Phone:888-279-0002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-04
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.013108101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional