Healthcare Provider Details

I. General information

NPI: 1376271908
Provider Name (Legal Business Name): LEANING INTO LIVING COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2022
Last Update Date: 08/11/2022
Certification Date: 08/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3450 N LAKE SHORE DR APT 3204
CHICAGO IL
60657-2863
US

IV. Provider business mailing address

3450 N LAKE SHORE DR APT 3204
CHICAGO IL
60657-2863
US

V. Phone/Fax

Practice location:
  • Phone: 954-298-4321
  • Fax: 708-575-5752
Mailing address:
  • Phone: 954-298-4321
  • Fax: 708-575-5752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. NATHANIEL SCHAPIRO
Title or Position: LICENSED CLINICAL PSYCHOLOGIST
Credential: PSY.D.
Phone: 954-298-4321