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General NPI Number Information
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NPI Number | 1336449891
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Entity Type | Organization
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Legal Business Name | WELLNESS COUNSELING ASSOCIATES, LLC
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Dates
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Enumeration Date | 10/29/2010
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Last Update Date | 10/29/2010
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Provider Practice Location Address
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Address Line | 2550 CRAWFORD AVE
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City | EVANSTON
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State | IL
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Zip | 60201-4900
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Country | US
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Telephone | 773-850-0270
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Fax |
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Provider Business Mailing Address
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Address Line | 5316 N OKETO AVE
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City | CHICAGO
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State | IL
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Zip | 60656-1761
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Country | US
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Telephone | 773-850-0270
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Fax |
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Authorized Official
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Title or Position | OWNER/ THERAPIST
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Name | WILLIAM ANDREW YOUNG
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Credential | LCPC, CADC
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Telephone | 773-850-0270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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