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General NPI Number Information
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NPI Number | 1316599731
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Entity Type | Organization
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Legal Business Name | TAMARA HUBBARD, LCPC, LLC
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Dates
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Enumeration Date | 07/16/2019
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Last Update Date | 11/08/2022
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Provider Practice Location Address
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Address Line | 4160 IL ROUTE 83 STE 210
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City | LONG GROVE
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State | IL
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Zip | 60047-8034
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Country | US
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Telephone | 847-957-7575
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Fax |
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Provider Business Mailing Address
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Address Line | 4160 IL ROUTE 83 STE 210
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City | LONG GROVE
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State | IL
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Zip | 60047-8034
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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/COUNSELOR
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Name | TAMARA HUBBARD
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Credential | LCPC
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Telephone | 847-957-7575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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