Provider Demographics
NPI:1932246469
Name:METROKA, DEBORAH B (LCPC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:B
Last Name:METROKA
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 1:730 OAKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:ALGONQUIN
Mailing Address - State:IL
Mailing Address - Zip Code:60102-2008
Mailing Address - Country:US
Mailing Address - Phone:847-658-6684
Mailing Address - Fax:847-458-7778
Practice Address - Street 1:880 E OAK ST
Practice Address - Street 2:UNIT 1
Practice Address - City:LAKE IN THE HILLS
Practice Address - State:IL
Practice Address - Zip Code:60156-6181
Practice Address - Country:US
Practice Address - Phone:847-658-6684
Practice Address - Fax:847-458-7778
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-006344101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional