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NPI 1306576814

NPI 1306576814 : CRESCENT AND CROWN THERAPY LLC : CHICAGO, IL

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General NPI Number Information
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    NPI Number           |    1306576814
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    Entity Type          |    Organization 
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    Legal Business Name  |    CRESCENT AND CROWN THERAPY LLC 
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Dates
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    Enumeration Date     |    06/16/2022
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    Last Update Date     |    05/15/2024
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Provider Practice Location Address
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    Address Line         |    661 W LAKE ST STE 2S 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60661-1034
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    Country              |    US
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    Telephone            |    708-943-7514
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    661 W LAKE ST STE 2S 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60661-1034
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     ASHLEY  HUNT 
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    Credential           |    MSW, LCSW
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    Telephone            |    718-749-3386
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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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