Provider Demographics
NPI:1407679111
Name:WARGO, MICHELE (MA LCPC)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:WARGO
Suffix:
Gender:F
Credentials:MA LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 W OLD NORTHWEST HWY STE 302C
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-6852
Mailing Address - Country:US
Mailing Address - Phone:224-203-2011
Mailing Address - Fax:
Practice Address - Street 1:525 W OLD NORTHWEST HWY STE 302C
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-6852
Practice Address - Country:US
Practice Address - Phone:224-203-2011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-02
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.016487101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional