Provider Demographics
NPI:1386944510
Name:SMURZYNSKI, BARBARA ANN (LCPC)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:SMURZYNSKI
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13221 FORESTVIEW LN
Mailing Address - Street 2:
Mailing Address - City:CRESTWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60445-1307
Mailing Address - Country:US
Mailing Address - Phone:708-712-0747
Mailing Address - Fax:708-633-4531
Practice Address - Street 1:17255 OAK PARK AVE # UE
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-3401
Practice Address - Country:US
Practice Address - Phone:708-633-4533
Practice Address - Fax:708-633-4531
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-21
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178006954101YP2500X
IL180.008555101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL178006954OtherLICENSED PROFESSIONAL COUNSELOR
IL180.008555OtherLICENSED CLINICAL PROFESSIONAL COUNSELOR