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NPI Code Detail

MEDICARE: HEARTH FIRE COUNSELING LLC

MEDICARE: HEARTH FIRE COUNSELING LLC
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 Worker149019184IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1149019184OTHERILLICENSE

General Provider Information

NPI Number : 1861986291
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEARTH FIRE COUNSELING LLC
Provider Business Mailing Address
First Line : 333 N MICHIGAN AVE STE 704
Second Line :
City : CHICAGO
State : IL
Zip : 60601-3905
Country : US
Telephone Number : 224-707-0633
Fax Number :
Provider Business Practice Location Address
First Line : 333 N MICHIGAN AVE STE 704
Second Line :
City : CHICAGO
State : IL
Zip : 60601-3905
Country : US
Telephone Number : 224-707-0633
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DENNIS NGUYEN
Credential :
Telephone Number : 224-707-0633
Provider Enumeration Date : 06/19/2018
Last Update Date : 06/19/2018

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Directions to “HEARTH FIRE COUNSELING LLC ” Practice Location

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