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NPI Code Detail

MEDICARE: GREATER CHICAGO COUNSELING CENTER

MEDICARE: GREATER CHICAGO COUNSELING CENTER
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
1101YM0800XMental Health Counselor
2103T00000XPsychologist
31041C0700XClinical Social Worker
4103TC0700XClinical Psychologist

General Provider Information

NPI Number : 1649747858
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREATER CHICAGO COUNSELING CENTER
Provider Business Mailing Address
First Line : 480 N MCCLURG CT APT 513
Second Line :
City : CHICAGO
State : IL
Zip : 60611-5337
Country : US
Telephone Number : 312-595-1787
Fax Number :
Provider Business Practice Location Address
First Line : 480 N MCCLURG CT APT 513
Second Line :
City : CHICAGO
State : IL
Zip : 60611-5337
Country : US
Telephone Number : 312-595-1787
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. BARBARA GOSCHI
Credential :
Telephone Number : 312-595-1787
Provider Enumeration Date : 10/25/2018
Last Update Date : 10/25/2018

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Directions to “GREATER CHICAGO COUNSELING CENTER ” Practice Location

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