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General NPI Number Information
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NPI Number | 1255980223
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Entity Type | Organization
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Legal Business Name | NEW CONSTELLATIONS THERAPY
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Dates
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Enumeration Date | 09/11/2019
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 2109 W IRVING PARK RD
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City | CHICAGO
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State | IL
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Zip | 60618-3923
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Country | US
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Telephone | 773-692-4558
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Fax | 773-825-8188
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Provider Business Mailing Address
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Address Line | 2109 W IRVING PARK RD
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City | CHICAGO
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State | IL
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Zip | 60618-3923
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Country | US
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Telephone | 773-692-4558
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Fax | 773-825-8188
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Authorized Official
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Title or Position | FOUNDER & PSYCHOTHERAPIST
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Name | KELLY L GEORGE
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Credential | LCPC
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Telephone | 773-692-4558
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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