Provider Demographics
NPI:1740655414
Name:SALTER, JEANETTE LYNN (LCPC)
Entity type:Individual
Prefix:MS
First Name:JEANETTE
Middle Name:LYNN
Last Name:SALTER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:JEANETTE
Other - Middle Name:LYNN
Other - Last Name:MAZEIKIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC
Mailing Address - Street 1:1590 N RAND RD STE 202
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60074-8510
Mailing Address - Country:US
Mailing Address - Phone:224-374-7135
Mailing Address - Fax:224-385-1631
Practice Address - Street 1:1590 N RAND RD STE 202
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60074-8510
Practice Address - Country:US
Practice Address - Phone:224-374-7135
Practice Address - Fax:224-385-1631
Is Sole Proprietor?:No
Enumeration Date:2015-12-07
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.012965101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional