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General NPI Number Information
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NPI Number | 1285678243
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Entity Type | Individual
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Provider Name | JAMES BISSELL MA, LCPC
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Gender | Male
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Dates
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Enumeration Date | 06/16/2006
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Last Update Date | 10/01/2007
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Provider Practice Location Address
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Address Line | 5214 N WESTERN AVE SUITE 151
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City | CHICAGO
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State | IL
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Zip | 60625-2589
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Country | US
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Telephone | 312-458-9215
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Fax |
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Provider Business Mailing Address
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Address Line | 1968 W FOSTER AVE
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City | CHICAGO
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State | IL
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Zip | 60640-1079
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Country | US
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Telephone | 773-334-8812
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State | IL
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