Healthcare Provider Details

I. General information

NPI: 1386441046
Provider Name (Legal Business Name): CATHARSIS COUNSELING AND ART THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4422 N RAVENSWOOD AVE PMB 23
CHICAGO IL
60640-5803
US

IV. Provider business mailing address

4422 N RAVENSWOOD AVE PMB 23
CHICAGO IL
60640-5803
US

V. Phone/Fax

Practice location:
  • Phone: 872-246-0464
  • Fax:
Mailing address:
  • Phone: 872-246-0464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: STEPHANIE LIEBL
Title or Position: FOUNDER, EXECUTIVE DIRECTOR
Credential: LCPC, ATR
Phone: 872-246-0466