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General NPI Number Information
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NPI Number | 1093253023
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Entity Type | Organization
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Legal Business Name | EMG COUNSELING LTD
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Dates
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Enumeration Date | 02/09/2017
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 230 W DIVISION ST APT 605
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City | CHICAGO
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State | IL
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Zip | 60610-7687
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Country | US
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Telephone | 740-507-4367
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Fax |
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Provider Business Mailing Address
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Address Line | 1300 W BELMONT AVE STE 14
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City | CHICAGO
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State | IL
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Zip | 60657-3200
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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 | THERAPIST
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Name | EMILY GRZELAKOWSKI
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Credential | LCSW
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Telephone | 740-507-4367
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 149016373
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License Number State | IL
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