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General NPI Number Information
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NPI Number | 1194330993
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Entity Type | Organization
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Legal Business Name | COLIBRI COUNSELING
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Dates
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Enumeration Date | 09/09/2020
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 4711 N BROADWAY ST STE 105
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City | CHICAGO
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State | IL
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Zip | 60640-4908
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Country | US
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Telephone | 312-508-8676
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Fax | 872-268-7990
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Provider Business Mailing Address
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Address Line | 4711 N BROADWAY ST STE 105
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City | CHICAGO
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State | IL
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Zip | 60640-4908
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Country | US
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Telephone | 312-508-8676
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | HECTOR L TORRES
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Credential | PSY.D.
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Telephone | 312-508-8676
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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