Doctor Name: | MS. NANCY L GLEAVES |
NPI Number: | 1124136197 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, LCPC, NCACII |
License Number: | 10523 |
Business Practice Address: | 3220 W 98th St Evergreen Park, IL - 608053000 |
Business Phone Number: | 7084222885 |
Business Fax Number: | 7084227161 |
Mailing Address: | 3220 W 98th St, EVERGREEN PARK |
State: | IL |
Postal Code: | 608053000 |
Phone Number: | 7084222885 |
Fax Number: | 7084227161 |
NPI Enumeration Date: | 08/29/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 10523 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |