Healthcare Provider Details

I. General information

NPI: 1528500162
Provider Name (Legal Business Name): GUADA PSYCHOLOGICAL SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2016
Last Update Date: 02/09/2024
Certification Date: 02/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 E WOODFIELD RD STE 905
SCHAUMBURG IL
60173-5137
US

IV. Provider business mailing address

1701 E WOODFIELD RD STE 905
SCHAUMBURG IL
60173-5137
US

V. Phone/Fax

Practice location:
  • Phone: 847-797-4699
  • Fax:
Mailing address:
  • Phone: 847-797-4699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number071.009370
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: KATHLEEN GUADA
Title or Position: OWNER
Credential:
Phone: 847-989-0248