Provider Demographics
NPI:1740611037
Name:MAZEK-VANN, ANNA (LCPC, CDVP,NCC)
Entity type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:
Last Name:MAZEK-VANN
Suffix:
Gender:F
Credentials:LCPC, CDVP,NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 E WOODFIELD RD STE 106
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4763
Mailing Address - Country:US
Mailing Address - Phone:847-240-5080
Mailing Address - Fax:847-240-1977
Practice Address - Street 1:800 E WOODFIELD RD STE 106
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4763
Practice Address - Country:US
Practice Address - Phone:847-240-5080
Practice Address - Fax:847-240-1977
Is Sole Proprietor?:No
Enumeration Date:2013-12-11
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.008813101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional