Healthcare Provider Details

I. General information

NPI: 1073484812
Provider Name (Legal Business Name): WELCOME BACK COUNSELING & CONSULTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2025
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8143 S PERRY AVE
CHICAGO IL
60620-1231
US

IV. Provider business mailing address

PO BOX 199217
CHICAGO IL
60619-0025
US

V. Phone/Fax

Practice location:
  • Phone: 773-372-5050
  • Fax:
Mailing address:
  • Phone: 773-372-5050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: BRIAN A SKINNER
Title or Position: PRESIDENT/CEO
Credential: LCSW
Phone: 773-372-5050