Provider Demographics
NPI:1992487227
Name:JAZWINSKI, TAMARA ARETA (MED, LPC)
Entity type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:ARETA
Last Name:JAZWINSKI
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 FOX GLEN CT
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-1863
Mailing Address - Country:US
Mailing Address - Phone:847-304-0780
Mailing Address - Fax:
Practice Address - Street 1:901 FOX GLEN CT
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-1863
Practice Address - Country:US
Practice Address - Phone:847-304-0780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-04
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.019213101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional