Provider Demographics
NPI:1982355475
Name:SICKLER, JENNI VICTORIA (MA, LCPC, ATR)
Entity Type:Individual
Prefix:
First Name:JENNI
Middle Name:VICTORIA
Last Name:SICKLER
Suffix:
Gender:F
Credentials:MA, LCPC, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:661 W LAKE ST STE 2S
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661-1034
Mailing Address - Country:US
Mailing Address - Phone:312-588-9261
Mailing Address - Fax:
Practice Address - Street 1:3717 N RAVENSWOOD AVE
Practice Address - Street 2:SUITE 239
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613
Practice Address - Country:US
Practice Address - Phone:312-588-9261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-16
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.015111101YP2500X
IL180.014615101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional