Provider Demographics
NPI:1033903737
Name:MORENO, ANA (LPC)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:MORENO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6801 W CLEVELAND ST
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-2603
Mailing Address - Country:US
Mailing Address - Phone:815-354-5093
Mailing Address - Fax:
Practice Address - Street 1:4905 OLD ORCHARD CTR STE 422
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-4738
Practice Address - Country:US
Practice Address - Phone:312-620-1420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.020533101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional