MEDICARE: ENCOURAGE COUNSELING, 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
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1801562590
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENCOURAGE COUNSELING, PLLC

Provider Business Mailing Address
First Line	:	9422 S LONGWOOD DR
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-6342
Country	:	US
Telephone Number	:	773-919-7598
Fax Number	:

Provider Business Practice Location Address
First Line	:	1655 S BLUE ISLAND AVE # 572
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-2133
Country	:	US
Telephone Number	:	773-919-7598
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DONNA VINEGAR
Credential	:	LCPC
Telephone Number	:	773-919-7598

Provider Enumeration Date	:	08/21/2021
Last Update Date	:	08/21/2021

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