Healthcare Provider Details

I. General information

NPI: 1407086192
Provider Name (Legal Business Name): ANNA HORVATH MACP;AT, LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2009
Last Update Date: 11/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1716 S MORGAN ST # 2F
CHICAGO IL
60608-2317
US

IV. Provider business mailing address

1716 S MORGAN ST # 2F
CHICAGO IL
60608-2317
US

V. Phone/Fax

Practice location:
  • Phone: 773-988-8825
  • Fax:
Mailing address:
  • Phone: 773-988-8825
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number178.003775
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180.007361
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: