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General NPI Number Information
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NPI Number | 1275692196
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Entity Type | Organization
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Legal Business Name | CENTER FOR ASSESSMENT AND PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 06/24/2008
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Provider Practice Location Address
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Address Line | 400 W LIBERTY SUITE C
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City | WHEATON
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State | IL
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Zip | 60187
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Country | US
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Telephone | 630-260-1570
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Fax | 630-260-1576
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Provider Business Mailing Address
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Address Line | 400 W LIBERTY SUITE C
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City | WHEATON
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State | IL
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Zip | 60187
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Country | US
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Telephone | 630-260-1570
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Fax | 630-260-1576
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | JULIA M KLCO
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Credential | PSY D
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Telephone | 630-546-6803
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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 | 71007031
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149010619
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071006135
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License Number State | IL
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