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General NPI Number Information
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NPI Number | 1235584426
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Entity Type | Organization
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Legal Business Name | SEAN WELSH, PSYD LLC
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Dates
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Enumeration Date | 04/26/2016
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Last Update Date | 04/26/2016
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Provider Practice Location Address
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Address Line | 1613 W HURON ST
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City | CHICAGO
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State | IL
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Zip | 60622-5607
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Country | US
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Telephone | 773-414-1727
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Fax |
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Provider Business Mailing Address
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Address Line | 1613 W HURON ST
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City | CHICAGO
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State | IL
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Zip | 60622-5607
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Country | US
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Telephone | 773-414-1727
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Fax |
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Authorized Official
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Title or Position | FOUNDER/CLINICAL PSYCHOLOGIST
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Name | DR. SEAN F WELSH
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Credential | PSYD
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Telephone | 773-414-1727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071.008552
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License Number State | IL
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