Healthcare Provider Details

I. General information

NPI: 1093619744
Provider Name (Legal Business Name): BRIGHT HARBOR COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 W GORDON TER APT 4M
CHICAGO IL
60613-2264
US

IV. Provider business mailing address

720 W GORDON TER APT 4M
CHICAGO IL
60613-2264
US

V. Phone/Fax

Practice location:
  • Phone: 872-246-5053
  • Fax:
Mailing address:
  • Phone: 872-246-5053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: BRENDAN GEANEY
Title or Position: FOUNDER & CLINICAL THERAPIST
Credential: LCPC LMHC
Phone: 872-246-5053