Provider Demographics
NPI:1922839182
Name:DING, DRAGON (LPC)
Entity type:Individual
Prefix:MR
First Name:DRAGON
Middle Name:
Last Name:DING
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7425 N SHERIDAN RD APT 3E
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-2057
Mailing Address - Country:US
Mailing Address - Phone:856-745-8200
Mailing Address - Fax:
Practice Address - Street 1:1000 W DIVERSEY PKWY STE 275
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-1879
Practice Address - Country:US
Practice Address - Phone:773-281-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178020463101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional