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General NPI Number Information
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NPI Number | 1013578624
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Entity Type | Organization
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Legal Business Name | SCT COUNSELING
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Dates
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Enumeration Date | 06/25/2019
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Last Update Date | 02/19/2020
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Provider Practice Location Address
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Address Line | 11948 S WESTERN AVE
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City | CHICAGO
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State | IL
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Zip | 60643
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Country | US
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Telephone | 708-299-6528
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Fax |
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Provider Business Mailing Address
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Address Line | 11848 S WESTERN AVE
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City | CHICAGO
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State | IL
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Zip | 60643-4734
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Country | US
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Telephone | 312-646-9744
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHANNON C COLAR
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Credential | LCPC
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Telephone | 312-646-9744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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