Provider Demographics
NPI:1699233825
Name:MARESKI, HOLLY JEAN (LCSW, CADC)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:JEAN
Last Name:MARESKI
Suffix:
Gender:F
Credentials:LCSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16W639 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:BENSENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60106-2327
Mailing Address - Country:US
Mailing Address - Phone:630-930-3477
Mailing Address - Fax:
Practice Address - Street 1:450 E 22ND ST STE 150
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-6118
Practice Address - Country:US
Practice Address - Phone:630-930-3477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)