Provider Demographics
NPI:1952790768
Name:AWADALLAH, NADJEH RIBHI (MA, EDD, LCPC)
Entity Type:Individual
Prefix:DR
First Name:NADJEH
Middle Name:RIBHI
Last Name:AWADALLAH
Suffix:
Gender:M
Credentials:MA, EDD, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2013 FARMINGTON LAKES DR APT 7
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:IL
Mailing Address - Zip Code:60543-8116
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2013 FARMINGTON LAKES DR APT 7
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:IL
Practice Address - Zip Code:60543-8116
Practice Address - Country:US
Practice Address - Phone:414-350-1671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-16
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180009456101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health