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General NPI Number Information
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NPI Number | 1376262642
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Entity Type | Organization
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Legal Business Name | CEM MENTAL HEALTHCARE & COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 08/22/2022
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Last Update Date | 08/22/2022
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Provider Practice Location Address
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Address Line | 5447 W. ADDISON STREET
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City | CHICAGO
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State | IL
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Zip | 60641
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Country | US
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Telephone | 412-853-2586
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Fax |
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Provider Business Mailing Address
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Address Line | 6236 N HOYNE AVENUE APT AB
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City | CHICAGO
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State | IL
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Zip | 60659
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Country | US
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Telephone | 412-853-2586
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Fax |
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Authorized Official
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Title or Position | CEO/PRESICENT
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Name | DR. AUGUSTINE LANSANA
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Credential | PHD
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Telephone | 412-853-2586
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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