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General NPI Number Information
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NPI Number | 1083012249
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Entity Type | Organization
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Legal Business Name | WINDY CITY COUNSELING LLC
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Dates
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Enumeration Date | 12/19/2014
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Last Update Date | 12/19/2014
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Provider Practice Location Address
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Address Line | 1 E WACKER DR SUITE 630
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City | CHICAGO
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State | IL
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Zip | 60601-1474
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Country | US
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Telephone | 312-860-0480
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Fax |
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Provider Business Mailing Address
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Address Line | 2220 HARTZELL ST
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City | EVANSTON
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State | IL
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Zip | 60201-1424
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Country | US
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Telephone | 312-860-0480
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MS. JENNIFER GRAY
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Credential | LCPC, CADC
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Telephone | 312-860-0480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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