Provider Demographics
NPI:1538583265
Name:MICHALOWSKI, DAVID (LCPC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:MICHALOWSKI
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 N DRAKE AVE
Mailing Address - Street 2:UNIT E
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-6278
Mailing Address - Country:US
Mailing Address - Phone:630-621-5361
Mailing Address - Fax:
Practice Address - Street 1:300 W ADAMS ST
Practice Address - Street 2:#514
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60606-5101
Practice Address - Country:US
Practice Address - Phone:312-578-9990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-17
Last Update Date:2014-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.008546101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health