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General NPI Number Information
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NPI Number | 1285272401
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Entity Type | Organization
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Legal Business Name | VERDANDI ANXIETY CLINIC & CONSULTING LLC
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Dates
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Enumeration Date | 12/18/2019
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Last Update Date | 12/18/2019
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Provider Practice Location Address
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Address Line | 501 W OGDEN AVE STE 6
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City | HINSDALE
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State | IL
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Zip | 60521-3184
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Country | US
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Telephone | 630-280-8900
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Fax |
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Provider Business Mailing Address
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Address Line | 501 W OGDEN AVE STE 6
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City | HINSDALE
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State | IL
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Zip | 60521-3184
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Country | US
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Telephone | 630-280-8900
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICIAN
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Name | DR. ELLEN C JORSTAD-STEIN
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Credential | PH.D.
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Telephone | 630-280-8900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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