Provider Demographics
NPI:1942707369
Name:SIKARAS, PHOTINI (MS, LCPC)
Entity type:Individual
Prefix:MS
First Name:PHOTINI
Middle Name:
Last Name:SIKARAS
Suffix:
Gender:F
Credentials:MS, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1860 W WINCHESTER RD STE 205
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-5317
Mailing Address - Country:US
Mailing Address - Phone:847-224-1455
Mailing Address - Fax:
Practice Address - Street 1:1860 W WINCHESTER RD
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-5351
Practice Address - Country:US
Practice Address - Phone:847-224-1455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-11
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.011933101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional