Provider Demographics
NPI:1962746685
Name:CERMAK, ELIZABETH KATHERINE (LCPC, NCC)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:KATHERINE
Last Name:CERMAK
Suffix:
Gender:F
Credentials:LCPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 BUTTERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:NORTH AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60542-1317
Mailing Address - Country:US
Mailing Address - Phone:630-750-2311
Mailing Address - Fax:
Practice Address - Street 1:319 BUTTERFIELD RD
Practice Address - Street 2:
Practice Address - City:NORTH AURORA
Practice Address - State:IL
Practice Address - Zip Code:60542-1317
Practice Address - Country:US
Practice Address - Phone:630-750-2311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-19
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.007461101YP2500X
IL180007461101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional