Provider Demographics
NPI:1801285101
Name:MARSHALL, AZIZI (LCPC)
Entity type:Individual
Prefix:MS
First Name:AZIZI
Middle Name:
Last Name:MARSHALL
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 1:2600 WARRENVILLE ROAD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1761
Mailing Address - Country:US
Mailing Address - Phone:847-477-8244
Mailing Address - Fax:
Practice Address - Street 1:2600 WARRENVILLE ROAD
Practice Address - Street 2:SUITE 205
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1761
Practice Address - Country:US
Practice Address - Phone:847-477-8244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-09
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.009321101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional