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General NPI Number Information
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NPI Number | 1043074057
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Entity Type | Organization
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Legal Business Name | ADULT THERAPY ALLIANCE, PLLC
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Dates
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Enumeration Date | 02/09/2024
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 1008 E GENEVA RD
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City | WHEATON
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State | IL
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Zip | 60187-2816
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Country | US
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Telephone | 630-246-2944
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Fax |
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Provider Business Mailing Address
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Address Line | 1005 APPLE CT
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City | AURORA
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State | IL
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Zip | 60505-1456
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Country | US
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Telephone | 630-386-5001
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | VINCENT DHAN
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Credential | LCSW, CADC
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Telephone | 630-386-5001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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