Healthcare Provider Details

I. General information

NPI: 1265359442
Provider Name (Legal Business Name): CULTUROOTS COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 W WASHINGTON ST STE 1506
CHICAGO IL
60602-3220
US

IV. Provider business mailing address

650 N MORGAN ST APT 304
CHICAGO IL
60642-6545
US

V. Phone/Fax

Practice location:
  • Phone: 708-317-8182
  • Fax: 312-873-4034
Mailing address:
  • Phone: 708-317-8182
  • Fax: 312-873-4034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: ANKUR VARMA
Title or Position: OWNER
Credential: LCPC
Phone: 708-317-8182