Healthcare Provider Details

I. General information

NPI: 1831968361
Provider Name (Legal Business Name): PATHWAY TO HOPE THERAPEUTIC SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

225 ROB ROY LN APT C
PROSPECT HEIGHTS IL
60070-2858
US

IV. Provider business mailing address

225 ROB ROY LN APT C
PROSPECT HEIGHTS IL
60070-2858
US

V. Phone/Fax

Practice location:
  • Phone: 773-636-9357
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: NICOLE LOCHIRCO
Title or Position: OWNER
Credential: LCPC
Phone: 773-636-9357