Provider Demographics
NPI:1194206318
Name:ZIECIK, KATARZYNA (LPC)
Entity type:Individual
Prefix:
First Name:KATARZYNA
Middle Name:
Last Name:ZIECIK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4919 W CUYLER AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-1787
Mailing Address - Country:US
Mailing Address - Phone:773-706-7008
Mailing Address - Fax:
Practice Address - Street 1:9645 LINCOLNWAY LN STE 207A
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-1908
Practice Address - Country:US
Practice Address - Phone:773-706-7008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-25
Last Update Date:2018-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178012990101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor