Provider Demographics
NPI:1801254263
Name:KRAKOWSKY, JESSICA (LCPC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:KRAKOWSKY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6006 159TH ST BLDG C
Mailing Address - Street 2:
Mailing Address - City:OAK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60452-2904
Mailing Address - Country:US
Mailing Address - Phone:708-535-7320
Mailing Address - Fax:708-535-7571
Practice Address - Street 1:6006 159TH ST BLDG C
Practice Address - Street 2:
Practice Address - City:OAK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60452-2904
Practice Address - Country:US
Practice Address - Phone:708-535-7320
Practice Address - Fax:708-535-7571
Is Sole Proprietor?:No
Enumeration Date:2016-02-01
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.009553101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional