Individual provider · Type 1 NPI

Jackson Mancuso, LPC

Professional Counselor · Lake Forest, IL

NPI number 1780406512 Active

Practice location

1 Westminster Pl Ste 101
Lake Forest, IL 60045-5511

Call (847) 919-9096 Map

Mailing address

330 E Sheridan Pl
Lake Bluff, IL 60044-2637

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500X178.020916 (IL)

Professional Counselor: Definition to come...

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About NPI 1780406512

Jackson Mancuso, LPC's National Provider Identifier is 1780406512, issued on Oct 31, 2024. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Lake Forest, IL. The record was last updated on Oct 31, 2024.