Provider Demographics
NPI:1114733490
Name:DANA PAULEY LCPC LLC
Entity type:Organization
Organization Name:DANA PAULEY LCPC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAULEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:630-217-0442
Mailing Address - Street 1:155 W PRAIRIEFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:IL
Mailing Address - Zip Code:60112-4142
Mailing Address - Country:US
Mailing Address - Phone:630-217-0442
Mailing Address - Fax:
Practice Address - Street 1:155 W PRAIRIEFIELD AVE
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:IL
Practice Address - Zip Code:60112-4142
Practice Address - Country:US
Practice Address - Phone:630-217-0442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty