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General NPI Number Information
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NPI Number | 1275166480
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Entity Type | Organization
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Legal Business Name | PROSPECTION COUNSELING LLC
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Dates
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Enumeration Date | 02/16/2020
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Last Update Date | 07/30/2020
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Provider Practice Location Address
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Address Line | 3005 MACARTHUR BLVD STE 207
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City | NORTHBROOK
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State | IL
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Zip | 60062-1901
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Country | US
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Telephone | 847-306-3686
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Fax |
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Provider Business Mailing Address
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Address Line | 955 BLACKHAWK LN
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City | RIVERWOODS
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State | IL
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Zip | 60015-2420
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Country | US
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Telephone | 847-306-3686
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LISA MOSS
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Credential | LCSW
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Telephone | 847-306-3686
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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