Provider Demographics
NPI:1386941896
Name:JANKIEWICZ, BEATA D (LCPC, CADC, ATR)
Entity type:Individual
Prefix:
First Name:BEATA
Middle Name:D
Last Name:JANKIEWICZ
Suffix:
Gender:F
Credentials:LCPC, CADC, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 W GOLF RD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60195-5179
Mailing Address - Country:US
Mailing Address - Phone:708-228-9215
Mailing Address - Fax:
Practice Address - Street 1:120 W GOLF RD
Practice Address - Street 2:SUITE 209
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60195-5179
Practice Address - Country:US
Practice Address - Phone:708-228-9215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-17
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180007257101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health