Healthcare Provider Details

I. General information

NPI: 1245785955
Provider Name (Legal Business Name): ABIGAIL HENNING SALAT ED.D, LCPC, NCSP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2016
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 W BELMONT AVE
CHICAGO IL
60657-3200
US

IV. Provider business mailing address

4347 N RICHMOND ST APT 1S
CHICAGO IL
60618-1466
US

V. Phone/Fax

Practice location:
  • Phone: 224-392-2897
  • Fax:
Mailing address:
  • Phone: 847-721-6680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number1105956
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.017603
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: