| NPI | 1225310865 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL SMITH Director 312-554-9934 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149014748) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 20992) |
| 103TC0700X Psychologist, Clinical (Licence: IL 180007270) | |
| 106H00000X Marriage & Family Therapist (Licence: GA IMFT-125) | |
| Enumeration Date | 2011-09-09 |
| Last Update Date | 2016-08-26 |