MS. ANDREA GUNDERSEN LCPC
NPI 1730479312
Counselor - Professional in Chicago, IL
Active since April 15, 2011
About Ms. Andrea Gundersen Lcpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MS. ANDREA GUNDERSEN LCPC (NPI 1730479312) is an individual professional provider in Chicago, Illinois, licensed in Illinois (180.007804) and active in the NPI registry since April 2011.
NPPES Registry Identity
NPI1730479312
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameMS. ANDREA GUNDERSENCredential: LCPC
Location Address4753 N BROADWAY ST, SUITE 510Chicago, IL 60640-5266
Mailing Address7064 N Greenview AveChicago, IL 60626-2830 · (847) 902-0454
Phone(847) 902-0454
Sole ProprietorYes
Enumeration DateApril 15, 2011
✔ NPI 1730479312 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in IL · 180.007804
4753 N BROADWAY ST, Chicago, IL 60640
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Psychologist (Clinical)
4753 N BROADWAY ST, SUITE 530
CHICAGO, IL 60640
CHICAGO, IL 60640
Social Worker (Clinical)
4753 N BROADWAY ST, SUITE 903
CHICAGO, IL 60640
CHICAGO, IL 60640
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1730479312, enumerated as an "individual" on April 15, 2011.
The provider is located at 4753 N BROADWAY ST SUITE 510 CHICAGO, IL 60640 and the phone number is (847) 902-0454.
Counselor with taxonomy code 101YP2500X and a focus in Professional.
