Jacqueline Perry Dauw, MA, LPC

Individual provider Active NPI Professional Counselor · Lemont, IL

NPI 1972895878 · NPPES record last updated May 27, 2011

Key facts

NPI
1972895878
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
178006487 (IL)
Practice address
40 Timberline Dr
Lemont, IL 60439-3848
Phone
(630) 248-4950
NPI assigned
May 10, 2011
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
178006487ILMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 178006487 IL Yes

Addresses

Primary practice location

40 Timberline Dr
Lemont, IL 60439-3848

Mailing address

2236 W Belden Ave
Apt. 2F
Chicago, IL 60647-3250
Phone (949) 439-2525

Other providers in Lemont, IL

All providers in Lemont, IL · Professional Counselor in Illinois

Sources for this page

Verify at the official NPI Registry.