Provider Demographics
NPI:1528755220
Name:CINQUEGRANI, CARLI (LPC-INTERN)
Entity type:Individual
Prefix:
First Name:CARLI
Middle Name:
Last Name:CINQUEGRANI
Suffix:
Gender:F
Credentials:LPC-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 PLAZA DR STE 301
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-5508
Mailing Address - Country:US
Mailing Address - Phone:630-812-8424
Mailing Address - Fax:
Practice Address - Street 1:2401 W OHIO ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-1266
Practice Address - Country:US
Practice Address - Phone:630-812-8424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-21
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.020106101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional