Provider Demographics
NPI:1427532753
Name:MENCONI, GINA (LPC)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:MENCONI
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 1:208 W EVERGREEN ST
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-5202
Mailing Address - Country:US
Mailing Address - Phone:708-209-9924
Mailing Address - Fax:
Practice Address - Street 1:1300 IROQUOIS AVE STE 145
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-1389
Practice Address - Country:US
Practice Address - Phone:630-305-0464
Practice Address - Fax:630-305-0211
Is Sole Proprietor?:No
Enumeration Date:2018-09-21
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.012726101YP2500X
IL178.005280101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL178.005280OtherLPC
IL180.012726OtherLCPC