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General NPI Number Information
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NPI Number | 1245646272
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Entity Type | Organization
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Legal Business Name | CATHOLIC CHARITIES OF THE ARCHDIOCESE OF CHICAGO
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Dates
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Enumeration Date | 07/10/2014
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Last Update Date | 05/31/2023
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Provider Practice Location Address
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Address Line | 1717 RAND RD
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City | DES PLAINES
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State | IL
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Zip | 60016-3509
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Country | US
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Telephone | 847-376-2100
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 N HERMITAGE AVE
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City | CHICAGO
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State | IL
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Zip | 60622-1161
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Country | US
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Telephone | 312-655-7167
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Fax |
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Authorized Official
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Title or Position | DEPARTMENT DIRECTOR
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Name | PAMELA F DAVIS
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Credential |
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Telephone | 312-655-7167
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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 |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #6
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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 | 04019
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License Number State | IL
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