Provider Demographics
NPI:1740090810
Name:DIETZ, JAMES THOMAS (LPC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:THOMAS
Last Name:DIETZ
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1226 SCHIEDLER DR
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:IL
Mailing Address - Zip Code:60510-8617
Mailing Address - Country:US
Mailing Address - Phone:630-664-9436
Mailing Address - Fax:
Practice Address - Street 1:101 W VALLETTE ST
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-4419
Practice Address - Country:US
Practice Address - Phone:844-984-7252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-10
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health