Provider Demographics
NPI:1669352951
Name:ABDIRAXMAN-ISSA, GILLIE D (LPC-INTERN)
Entity type:Individual
Prefix:
First Name:GILLIE
Middle Name:D
Last Name:ABDIRAXMAN-ISSA
Suffix:
Gender:F
Credentials:LPC-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:GRACE INTEGRATED LLC
Mailing Address - Street 2:414 PLAZA DR. STE 301
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-5508
Mailing Address - Country:US
Mailing Address - Phone:630-728-1744
Mailing Address - Fax:
Practice Address - Street 1:GRACE INTEGRATED LLC
Practice Address - Street 2:414 PLAZA DR. STE 301
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-6055
Practice Address - Country:US
Practice Address - Phone:630-728-1744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional