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NPI Code Detail

MEDICARE: HONEYCOMB PSYCHOTHERAPY & CONSULTATION PLLC

MEDICARE: HONEYCOMB PSYCHOTHERAPY & CONSULTATION PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1235905118
Entity Type Code : Organization
Provider Name (Legal Business Name) : HONEYCOMB PSYCHOTHERAPY & CONSULTATION PLLC
Provider Business Mailing Address
First Line : 5153 N CLARK ST STE 306
Second Line :
City : CHICAGO
State : IL
Zip : 60640-6850
Country : US
Telephone Number : 312-775-2440
Fax Number :
Provider Business Practice Location Address
First Line : 5153 N CLARK ST STE 306
Second Line :
City : CHICAGO
State : IL
Zip : 60640-6850
Country : US
Telephone Number : 312-775-2440
Fax Number :
Authorized Official
Title or Position : OWNER, PRESIDENT
Name : CRISTEN BROSSOK
Credential : LCSW
Telephone Number : 312-775-2440
Provider Enumeration Date : 11/30/2023
Last Update Date : 11/30/2023

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Directions to “HONEYCOMB PSYCHOTHERAPY & CONSULTATION PLLC ” Practice Location

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