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General NPI Number Information
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NPI Number | 1366466997
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Entity Type | Individual
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Provider Name | CAROLEE SHUDNOW LCPC
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Gender | Female
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5301 DEMPSTER ST 205
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City | SKOKIE
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State | IL
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Zip | 60077-1846
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Country | US
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Telephone | 773-405-3401
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Fax |
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Provider Business Mailing Address
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Address Line | 7033 N KEDZIE AVE 1613
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City | CHICAGO
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State | IL
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Zip | 60645-2845
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Country | US
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Telephone | 773-761-6827
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State | IL
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