Elizabeth Frances Blaha, LCPC

Individual provider Active NPI Professional Counselor · Lockport, IL

NPI 1043083744 · NPPES record last updated Nov 3, 2023

Key facts

NPI
1043083744
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
180012273 (IL)
Practice address
17758 S Mitchell LN
Lockport, IL 60441-4754
Phone
(708) 703-0171
NPI assigned
Nov 3, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
180012273ILMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180012273 IL Yes

Addresses

Primary practice location

17758 S Mitchell LN
Lockport, IL 60441-4754

Mailing address

17758 S Mitchell LN
Lockport, IL 60441-4754
Phone (708) 703-0171

Other providers in Lockport, IL

All providers in Lockport, IL · Professional Counselor in Illinois

Sources for this page

Verify at the official NPI Registry.