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General NPI Number Information
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NPI Number | 1013739812
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Entity Type | Individual
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Provider Name | MIN HSUAN LIN MA, LPC
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Gender | Female
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Dates
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Enumeration Date | 10/31/2024
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 2650 W MONTROSE AVE
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City | CHICAGO
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State | IL
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Zip | 60618-1560
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Country | US
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Telephone | 773-692-6857
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Fax |
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Provider Business Mailing Address
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Address Line | 2050 RIDGE AVE APT 2S
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City | EVANSTON
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State | IL
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Zip | 60201-2759
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 178.020773
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License Number State | IL
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