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General NPI Number Information
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NPI Number | 1235642596
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Entity Type | Organization
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Legal Business Name | TREECE AND ASSOCIATES PSYCHOTHERAPY AND COUNSELING
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Dates
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Enumeration Date | 11/08/2017
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Last Update Date | 11/08/2017
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Provider Practice Location Address
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Address Line | 688 N MILWAUKEE AVE
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City | CHICAGO
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State | IL
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Zip | 60642-5912
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Country | US
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Telephone | 615-948-8939
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Fax | 312-489-8293
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Provider Business Mailing Address
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Address Line | 8921 POTTAWATTAMI DR
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City | SKOKIE
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State | IL
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Zip | 60076-1907
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Country | US
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Telephone | 615-948-8939
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Fax |
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Authorized Official
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Title or Position | FOUNDER, MANAGING DIRECTOR
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Name | MANYA TREECE
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Credential | LCSW
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Telephone | 615-948-8939
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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 |
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License Number State |
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