Healthcare Provider Details

I. General information

NPI: 1447716931
Provider Name (Legal Business Name): VALERIE JAMES LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2019
Last Update Date: 02/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 W BELMONT AVE STE 400
CHICAGO IL
60657-3260
US

IV. Provider business mailing address

3152 W WILSON AVE APT 2N
CHICAGO IL
60625-4435
US

V. Phone/Fax

Practice location:
  • Phone: 773-880-1310
  • Fax:
Mailing address:
  • Phone: 215-290-3137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180009364
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: