Provider Demographics
NPI:1154976223
Name:POLACEK, BRITTANY E (MSE, LPC, NCC)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:E
Last Name:POLACEK
Suffix:
Gender:F
Credentials:MSE, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:977 LAKEVIEW PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1444
Mailing Address - Country:US
Mailing Address - Phone:224-202-7528
Mailing Address - Fax:
Practice Address - Street 1:977 LAKEVIEW PKWY STE 100
Practice Address - Street 2:
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1444
Practice Address - Country:US
Practice Address - Phone:224-202-7528
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-06
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.017169101YM0800X
WI4378-226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health