Provider Demographics
NPI:1811254816
Name:GRONEK, STACY (MS, LCPC, CADC)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:GRONEK
Suffix:
Gender:F
Credentials:MS, LCPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6718 MEADE PL
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60516-3179
Mailing Address - Country:US
Mailing Address - Phone:708-289-8838
Mailing Address - Fax:
Practice Address - Street 1:1100 JORIE BLVD STE 132
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523
Practice Address - Country:US
Practice Address - Phone:630-522-3124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-13
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)