Provider Demographics
NPI:1114549169
Name:XIONG, GEORGE LEE (MA, LCPC, ADHD-CCSP)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:LEE
Last Name:XIONG
Suffix:
Gender:
Credentials:MA, LCPC, ADHD-CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 SKOKIE BLVD UNIT 351
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2344
Mailing Address - Country:US
Mailing Address - Phone:763-267-1766
Mailing Address - Fax:
Practice Address - Street 1:770 SKOKIE BLVD UNIT 351
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-2344
Practice Address - Country:US
Practice Address - Phone:763-267-1766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-13
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.015933101YP2500X
IL180.015887101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional