Healthcare Provider Details

I. General information

NPI: 1326950726
Provider Name (Legal Business Name): MICHELLE HALM LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5547 N RAVENSWOOD AVE STE 201
CHICAGO IL
60640-1125
US

IV. Provider business mailing address

5547 N RAVENSWOOD AVE STE 201
CHICAGO IL
60640-1125
US

V. Phone/Fax

Practice location:
  • Phone: 773-219-2608
  • Fax:
Mailing address:
  • Phone: 773-219-2608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180018713
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: