Provider Demographics
NPI:1861005142
Name:VILLASENOR-SANCHEZ, MARISOL (MED , LCPC)
Entity type:Individual
Prefix:MRS
First Name:MARISOL
Middle Name:
Last Name:VILLASENOR-SANCHEZ
Suffix:
Gender:F
Credentials:MED , LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 W ADDISON ST APT 202
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-4447
Mailing Address - Country:US
Mailing Address - Phone:773-280-4498
Mailing Address - Fax:
Practice Address - Street 1:2919 N SOUTHPORT AVE APT 1
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-7387
Practice Address - Country:US
Practice Address - Phone:224-420-7519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-26
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.016712101YM0800X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health