Healthcare Provider Details

I. General information

NPI: 1184226110
Provider Name (Legal Business Name): KOJO NGORO COUNSELING AND CONSULTING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2020
Last Update Date: 11/13/2020
Certification Date: 11/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1616 E 50TH PL APT 8D
CHICAGO IL
60615-3111
US

IV. Provider business mailing address

1616 E 50TH PL APT 8D
CHICAGO IL
60615-3111
US

V. Phone/Fax

Practice location:
  • Phone: 929-525-4357
  • Fax:
Mailing address:
  • Phone: 708-297-8703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MR. AJ DELONEY IV
Title or Position: PSYCHOTHERAPIST/OWNER
Credential: LCSW
Phone: 929-525-4357