| NPI | 1750155537 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACI DONIELLE CONEY Licensed Clinical Social Worker 773-255-5636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-11-13 |
| Last Update Date | 2024-03-15 |