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Anita Johanson Maddox, LCPC
Developmental Therapist in Lake Villa, Illinois
NPI 1770623407

Anita Johanson Maddox is a Developmental Therapist based in Lake Villa, IL. Anita Johanson Maddox practices in Lake Villa, IL and has the professional credentials of LCPC. The NPI Number for Anita Johanson Maddox is 1770623407 and holds a License No. 180004644 (Illinois).

The current practice location address for Anita Johanson Maddox is 89 Cedar Ave, Lake Villa, IL and can be reached out via phone at 847-265-7300 and via fax at 847-265-7301.

Location: 89 Cedar Ave, Lake Villa, IL, 60046-0764
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1770623407
Provider Name
Anita Johanson Maddox
Credential
LCPC
Provider Entity Type
Individual
Gender
Female
Address
89 Cedar Ave, Lake Villa, IL, 60046-0764
Phone Number
847-265-7300
Fax Number
847-265-7301
Provider Enumeration Date
02/08/2007
Last Update Date
03/08/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
04932271 01 IL BLUE SHIELD
710957905 01 IL FEIN
institution
Provider Business Practice Location Address Details
Address
89 Cedar Ave
City
Lake Villa
State
Illinois
Zip
60046-8411
Phone Number
847-265-7300
Fax Number
847-265-7301
person
Provider Business Mailing Address Details
Address
89 Cedar Ave
City
Lake Villa
State
Illinois
Zip
60046-8411
Phone Number
847-265-7300
Fax Number
847-265-7301
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
AM47190798P (Illinois)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Developmental Therapist
Speciality
-
Taxonomy
222Q00000X
License No.
180004644 (Illinois)
Definition
A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Developmental Therapy Association. A developmental therapist evaluates children's global development in order to identify areas of developmental delay whether arising from physiological, neurological, or environmental factors, or a combination of factors; and designs, implements, and modifies therapeutic interventions for the child and the family to promote the child's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction in order to maximize functional independence and developmental homeostasis, and improve the quality of life at home and in the community; and provides consultation for the parents and other professionals working with the family on global development.
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