Healthcare Provider Details

I. General information

NPI: 1720090780
Provider Name (Legal Business Name): ST JAMES CATHEDRAL COUNSELING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 11/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 E WASHINGTON ST SUITE 301
CHICAGO IL
60602-2152
US

IV. Provider business mailing address

50 E WASHINGTON ST SUITE 301
CHICAGO IL
60602-2152
US

V. Phone/Fax

Practice location:
  • Phone: 312-252-9500
  • Fax: 312-337-9243
Mailing address:
  • Phone: 312-252-9500
  • Fax: 312-337-9243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. LUCIE M. PREBEL
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 312-337-5874