Healthcare Provider Details
I. General information
NPI: 1902561269
Provider Name (Legal Business Name): SPRING COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/02/2021
Last Update Date: 11/19/2021
Certification Date: 11/19/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2000 N RACINE AVE STE 2040
CHICAGO IL
60614-7006
US
IV. Provider business mailing address
2000 N RACINE AVE STE 2040
CHICAGO IL
60614-7006
US
V. Phone/Fax
- Phone: 773-715-1676
- Fax:
- Phone: 773-715-1676
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ALLYSON
WOLCOTT
Title or Position: PSYCHOTHERAPIST
Credential: LCPC
Phone: 773-715-1676