Healthcare Provider Details

I. General information

NPI: 1700658317
Provider Name (Legal Business Name): LELA COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2023
Last Update Date: 07/12/2024
Certification Date: 07/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4130 N KIMBALL AVE
CHICAGO IL
60618-2308
US

IV. Provider business mailing address

4130 N KIMBALL AVE
CHICAGO IL
60618-2308
US

V. Phone/Fax

Practice location:
  • Phone: 901-870-5938
  • Fax:
Mailing address:
  • Phone: 901-870-5938
  • 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: ALLISON GARLAND GREVEN
Title or Position: OWNER
Credential: LCSW
Phone: 901-870-5938