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General NPI Number Information
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NPI Number | 1225285661
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Entity Type | Organization
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Legal Business Name | NICOLE MEYER KLARICH, LCPC & ASSOCIATES, LLC
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Dates
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Enumeration Date | 08/27/2008
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Last Update Date | 08/27/2008
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Provider Practice Location Address
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Address Line | 2302 W. NORTH AVE. STE 1E
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City | CHICAGO
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State | IL
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Zip | 60647
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Country | US
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Telephone | 773-524-2685
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Fax | 773-524-2685
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Provider Business Mailing Address
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Address Line | 1700 N. ARTESIAN AVE - 1E
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City | CHICAGO
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State | IL
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Zip | 60647
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Country | US
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Telephone | 773-524-2685
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Fax | 773-524-2685
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Authorized Official
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Title or Position | OWNER/PSYCHOTHERAPIST
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Name | MS. NICOLE MEYER KLARICH
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Credential | LCPC
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Telephone | 773-524-2685
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 180-005468
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 180-005468
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 180-005468
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License Number State |
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