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General NPI Number Information
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NPI Number | 1073941233
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Entity Type | Organization
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Legal Business Name | HUE MAN SERVICE COUNSELING AND CONSULTING
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Dates
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Enumeration Date | 10/28/2013
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Last Update Date | 10/28/2013
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Provider Practice Location Address
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Address Line | 2505 W 63RD ST
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City | CHICAGO
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State | IL
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Zip | 60629-1617
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Country | US
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Telephone | 708-825-5337
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Fax | 708-331-6521
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Provider Business Mailing Address
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Address Line | 15663 KIMBARK AVE
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City | SOUTH HOLLAND
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State | IL
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Zip | 60473-1826
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Country | US
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Telephone | 708-825-5337
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOHNNY WHITE
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Credential | LCSW
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Telephone | 708-825-5337
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149006744
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License Number State | IL
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