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General NPI Number Information
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NPI Number | 1417579731
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Entity Type | Organization
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Legal Business Name | ONE TRUE NORTH LLC
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Dates
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Enumeration Date | 05/08/2020
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Last Update Date | 05/08/2020
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Provider Practice Location Address
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Address Line | 175 OLDE HALF DAY RD STE 100-6
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City | LINCOLNSHIRE
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State | IL
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Zip | 60069-3008
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Country | US
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Telephone | 847-748-2558
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Fax |
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Provider Business Mailing Address
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Address Line | 175 OLDE HALF DAY RD STE 100-6
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City | LINCOLNSHIRE
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State | IL
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Zip | 60069-3008
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Country | US
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Telephone | 847-748-2558
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTINE BURBACK
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Credential | LCPC NCC
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Telephone | 847-748-2558
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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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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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Taxonomy #3
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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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