Provider Demographics
NPI:1952558827
Name:MARK A PLETCHER, LCPC, PC
Entity type:Organization
Organization Name:MARK A PLETCHER, LCPC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:PLETCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LCPC
Authorized Official - Phone:847-204-2304
Mailing Address - Street 1:828 JUDSON AVE
Mailing Address - Street 2:#1
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-2463
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2550 CRAWFORD AVE
Practice Address - Street 2:#5
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4900
Practice Address - Country:US
Practice Address - Phone:847-204-2304
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-22
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180002915101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty