Provider Demographics
NPI:1912595158
Name:WAINMAN, ARIELLE (LPC)
Entity Type:Individual
Prefix:
First Name:ARIELLE
Middle Name:
Last Name:WAINMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ARIELLE
Other - Middle Name:
Other - Last Name:BAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:0N108 BEVERLY ST
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-2547
Mailing Address - Country:US
Mailing Address - Phone:309-253-8097
Mailing Address - Fax:
Practice Address - Street 1:0N108 BEVERLY ST
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-2547
Practice Address - Country:US
Practice Address - Phone:309-253-8097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-04
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.016433101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional