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General NPI Number Information
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NPI Number | 1356722110
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Entity Type | Organization
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Legal Business Name | INSIDE FAMILY COUNSELING, LLC
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Dates
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Enumeration Date | 06/17/2015
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Last Update Date | 09/21/2015
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Provider Practice Location Address
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Address Line | 110 E SCHILLER ST STE 228
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City | ELMHURST
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State | IL
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Zip | 60126-2822
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Country | US
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Telephone | 773-470-3106
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Fax |
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Provider Business Mailing Address
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Address Line | 255 N MICHIGAN AVE
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City | ELMHURST
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State | IL
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Zip | 60126-2735
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Country | US
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Telephone | 773-470-3106
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MIHAELA BERNARD
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Credential | LCPC
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Telephone | 773-470-3106
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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 | 180008911
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License Number State | IL
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