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General NPI Number Information
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NPI Number | 1215580972
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Entity Type | Organization
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Legal Business Name | ESHLEY SPITZER, LCPC, LLC
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Dates
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Enumeration Date | 07/22/2019
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Last Update Date | 07/22/2019
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Provider Practice Location Address
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Address Line | 2500 W BRADLEY PL STE 200
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City | CHICAGO
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State | IL
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Zip | 60618-4716
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Country | US
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Telephone | 773-977-0704
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Fax |
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Provider Business Mailing Address
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Address Line | 2500 W BRADLEY PL STE 200
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City | CHICAGO
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State | IL
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Zip | 60618-4716
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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 | LICENSED PROFESSIONAL COUNSELOR
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Name | ESHLEY SPITZER
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Credential | LCPC
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Telephone | 303-349-0606
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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 |
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License Number State |
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