Provider Demographics
NPI:1710160239
Name:LUX, BRIAN T (LCPC)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:T
Last Name:LUX
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 1:1605 W WILSON ST STE 106
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:IL
Mailing Address - Zip Code:60510-1608
Mailing Address - Country:US
Mailing Address - Phone:630-425-3190
Mailing Address - Fax:855-978-2577
Practice Address - Street 1:1605 W WILSON ST STE 106
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:IL
Practice Address - Zip Code:60510-1608
Practice Address - Country:US
Practice Address - Phone:630-425-3190
Practice Address - Fax:855-978-2577
Is Sole Proprietor?:No
Enumeration Date:2007-12-06
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180006540101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional