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General NPI Number Information
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NPI Number | 1205336377
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Entity Type | Organization
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Legal Business Name | ESPINAL CONSULTING CORPORATION
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Dates
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Enumeration Date | 02/15/2018
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 636 CHURCH ST STE 419C
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City | EVANSTON
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State | IL
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Zip | 60201-4580
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Country | US
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Telephone | 312-646-0809
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Fax |
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Provider Business Mailing Address
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Address Line | 636 CHURCH ST STE 419C
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City | EVANSTON
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State | IL
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Zip | 60201-4580
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Country | US
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Telephone | 312-646-0809
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. RICHARD ESPINAL
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Credential | LCPC
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Telephone | 312-646-0809
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180.011439
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License Number State | IL
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