Provider Demographics
NPI:1497474001
Name:MARAVELIAS, JASON (LCPC)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:MARAVELIAS
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:763 S ALDRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:ROUND LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60073-4244
Mailing Address - Country:US
Mailing Address - Phone:224-908-4199
Mailing Address - Fax:
Practice Address - Street 1:763 S ALDRIDGE LN
Practice Address - Street 2:
Practice Address - City:ROUND LAKE
Practice Address - State:IL
Practice Address - Zip Code:60073-4244
Practice Address - Country:US
Practice Address - Phone:224-908-4199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-25
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor