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General NPI Number Information
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NPI Number | 1194270108
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Entity Type | Organization
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Legal Business Name | CITY HAVEN COUNELING
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Dates
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Enumeration Date | 08/19/2016
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Last Update Date | 08/19/2016
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Provider Practice Location Address
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Address Line | 1735 N ASHLAND AVE SUITE 201
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City | CHICAGO
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State | IL
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Zip | 60622-1435
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Country | US
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Telephone | 312-489-7490
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Fax | 773-303-8837
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Provider Business Mailing Address
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Address Line | 1735 N ASHLAND AVE SUITE 201
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City | CHICAGO
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State | IL
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Zip | 60622-1435
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Country | US
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Telephone | 312-489-7490
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Fax | 773-303-8837
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Authorized Official
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Title or Position | OWNER/PRACTIONER
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Name | DR. KATHERINE MCNAIR HARDING
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Credential | PSYD
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Telephone | 312-489-7490
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 071008183
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License Number State | IL
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