Provider Demographics
NPI:1285460329
Name:VELAZQUEZ, JOANN (LCDC)
Entity type:Individual
Prefix:
First Name:JOANN
Middle Name:
Last Name:VELAZQUEZ
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 E DIEHL RD STE 550
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8206
Mailing Address - Country:US
Mailing Address - Phone:866-291-2393
Mailing Address - Fax:
Practice Address - Street 1:21518 STARGRASS DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-2924
Practice Address - Country:US
Practice Address - Phone:832-407-0212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17061101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)