Provider Demographics
NPI:1831703131
Name:MERTENS, COLLEEN (MA, LPC, CADC)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:MERTENS
Suffix:
Gender:F
Credentials:MA, LPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1331 W 75TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-9311
Mailing Address - Country:US
Mailing Address - Phone:630-527-5000
Mailing Address - Fax:630-527-5440
Practice Address - Street 1:1331 W 75TH ST STE 201
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-9311
Practice Address - Country:US
Practice Address - Phone:630-527-5000
Practice Address - Fax:630-527-5440
Is Sole Proprietor?:No
Enumeration Date:2020-09-03
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL33101101YA0400X
IL178.014978101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)