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General NPI Number Information
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NPI Number | 1164123766
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Entity Type | Organization
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Legal Business Name | GAEA COUNSELING CENTERS LLC
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Dates
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Enumeration Date | 03/13/2023
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Last Update Date | 03/13/2023
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Provider Practice Location Address
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Address Line | 2405 N SHEFFIELD AVE # 189
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City | CHICAGO
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State | IL
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Zip | 60614-8097
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Country | US
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Telephone | 847-754-8039
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Fax |
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Provider Business Mailing Address
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Address Line | 2405 N SHEFFIELD AVE # 189
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City | CHICAGO
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State | IL
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Zip | 60614-8097
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Country | US
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Telephone | 847-754-8039
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARIE BARNHART
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Credential |
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Telephone | 872-205-6167
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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 |
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License Number State |
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