Provider Demographics
NPI:1811282353
Name:GUTHER-ROGOWSKI, NICOLE LYNN (LCPC)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:LYNN
Last Name:GUTHER-ROGOWSKI
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 1:3385 N ARLINGTON HEIGHTS RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-7702
Mailing Address - Country:US
Mailing Address - Phone:847-890-3223
Mailing Address - Fax:
Practice Address - Street 1:3385 N ARLINGTON HEIGHTS RD
Practice Address - Street 2:SUITE C
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-7702
Practice Address - Country:US
Practice Address - Phone:847-890-3223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.006935101YP2500X
IL180009019101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional