Provider Demographics
NPI:1548653280
Name:JARAMILLO, LAURA (MS, LCPC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:JARAMILLO
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 1:160 PORT ROYAL CIR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-2048
Mailing Address - Country:US
Mailing Address - Phone:224-209-1866
Mailing Address - Fax:630-468-2600
Practice Address - Street 1:277 83RD STREET
Practice Address - Street 2:SUITE D
Practice Address - City:BURR RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60527
Practice Address - Country:US
Practice Address - Phone:630-891-3027
Practice Address - Fax:630-468-2600
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-05
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180011140101YP2500X
IL178010384101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional