MARILYN JOYCE FETTNER (NPI# 1104157890) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104157890 |
| Entity Type | Individual |
| Full Name | MARILYN JOYCE FETTNER |
| Credential | LCPC |
| Practice Address |
910 Skokie Blvd Suite 107 Northbrook IL 60062-4013 |
| Mailing Address |
1963 Skyelar Ct Highland Park IL 60035-4322 |
| Practice Telephone | 8478310079 |
| Mailing Telephone | 8478310079 |
| Enumeration Date | 2010-01-20 |
| Last Update Date | 2012-12-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
180.008430 | IL | Behavioral Health & Social Service Providers |
| Street Address |
910 SKOKIE BLVD SUITE 107 |
| City | NORTHBROOK |
| State | IL |
| Zip Code | 60062-4013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134166952 | Verne Noparstak | Psychologist | 910 Skokie Blvd, Suite 215, Northbrook, IL 60062-4013 | 2006-06-01 |
| 1801283247 | Leah Seligman | Counselor | 910 Skokie Blvd, Suite 215, Northbrook, IL 60062-4013 | 2015-04-23 |
| 1619362696 | Cody Todd | Counselor | 910 Skokie Blvd, Northbrook, IL 60062-4013 | 2015-04-06 |
| 1083009575 | Evan Byer | Psychologist | 910 Skokie Blvd, Suite 215, Northbrook, IL 60062-4013 | 2015-04-01 |
| 1578951497 | Peter Baker | Counselor | 910 Skokie Blvd, Suite 215, Northbrook, IL 60062-4013 | 2014-12-30 |
| 1902214364 | 5stars Home Care Services, Inc. | Homemaker | 910 Skokie Blvd, Suite #116, Northbrook, IL 60062-4013 | 2014-07-30 |
| 1306263173 | Kenneth Celiano | Psychologist | 910 Skokie Blvd, Suite 215, Northbrook, IL 60062-4013 | 2014-03-18 |
| 1740565126 | Affiliates In Counseling LLC | Marriage & Family Therapist | 910 Skokie Blvd, Suite 215, Northbrook, IL 60062-4013 | 2011-10-17 |
| 1568783074 | Margot Touris | Psychologist | 910 Skokie Blvd, Suite 207b, Northbrook, IL 60062-4013 | 2010-06-18 |
| 1356497069 | Gavin Mullen | Psychologist | 910 Skokie Blvd, 215, Northbrook, IL 60062-4013 | 2007-01-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508487067 | Cvs Aoc Services, L.L.C. | Optometrist | 936 Willow Road, Store 0141, Northbrook, IL 60062 | 2020-05-06 |
| 1386103885 | Jennifer Venegas | Behavior Technician | 5 Revere Dr Suit 120, Northbrook, IL 60062 | 2019-03-14 |
| 1720558281 | Taylor Hundley | Behavior Technician | 5 Revere Dr. Suite 120, Northbrook, IL 60062 | 2018-11-27 |
| 1609344027 | Melissa Cepeda | Behavior Technician | 5 Revere Dr Suite 120, Northbrook, IL 60062 | 2018-11-03 |
| 1235606658 | Candace Cheyenne Kaiser | Behavior Technician | 5 Revere Dr, Suite 120, Northbrook, IL 60062 | 2018-10-24 |
| 1275058745 | The Renfrew Center of Illinois | Counselor | 5 Revere Dr, Suite 100, Northbrook, IL 60062 | 2017-08-07 |
| 1467984773 | Ayzenshteyn Chiropractic | Chiropractor | 3210 Doolittle Dr., Northbrook, IL 60062 | 2017-03-28 |
| 1396282695 | Josephine Driscoll | Physician Assistant | 400 Skokie Blvd., Suite 450, Northbrook, IL 60062 | 2017-01-24 |
| 1396297842 | Lauren Raphael Lcsw LLC | Social Worker | 3050 Pheasant Creek Drive, Apt. 104, Northbrook, IL 60062 | 2016-11-01 |
| 1851847073 | Jassim Vailoces | Physical Therapist | 634 Academy Dr, Northbrook, IL 60062 | 2016-08-28 |
| Find all providers in zip 60062 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083240410 | Maribeth Gomez Germino | Counselor | 4201 Lake Cook Rd, Northbrook, IL 60062-1060 | 2020-03-17 |
| 1295389948 | Alice Shierk-booth | Counselor | 3000 Dundee Rd Ste 311, Northbrook, IL 60062-2434 | 2019-07-31 |
| 1457853558 | Barbara Dianne Demetrius-lallas | Counselor | 1859 Penfold Pl, Northbrook, IL 60062-6034 | 2018-03-05 |
| 1174032007 | Melissa Martin | Counselor | 5 Revere Dr Ste 100, Northbrook, IL 60062-1567 | 2017-09-22 |
| 1275058745 | The Renfrew Center of Illinois | Counselor | 5 Revere Dr, Suite 100, Northbrook, IL 60062 | 2017-08-07 |
| 1104360080 | Pamela Matos | Counselor | 3100 Dundee Rd Ste 101, Northbrook, IL 60062-2462 | 2016-12-12 |
| 1811374960 | Aaron Marsh | Counselor | 155 Revere Dr Ste 11, Northbrook, IL 60062-1558 | 2015-04-28 |
| 1811315526 | Tracy K Durkan | Counselor | 1535 Lake Cook Rd Ste 303, Northbrook, IL 60062-1452 | 2014-03-31 |
| 1780029652 | Jennifer Welbel | Counselor | 1500 Skokie Blvd Ste 305, Northbrook, IL 60062-4114 | 2013-05-06 |
| 1477852341 | Jane Ward Carlton | Counselor | 1363 Shermer Rd Ste 313, Northbrook, IL 60062-4575 | 2011-03-17 |
| Find all providers in NORTHBROOK | ||||
| City | NORTHBROOK |
| Zip Code | 60062 |
Please comment or provide details below to improve the information on MARILYN JOYCE FETTNER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.