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General NPI Number Information
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NPI Number | 1437718632
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Entity Type | Individual
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Provider Name | MEREDITH YEBRA LCPC, ART-BC
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Gender | Female
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Dates
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Enumeration Date | 06/11/2019
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 4610 N CLARK ST # 1203
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City | CHICAGO
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State | IL
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Zip | 60640-4620
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Country | US
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Telephone | 312-278-7628
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Fax |
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Provider Business Mailing Address
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Address Line | 4610 N CLARK ST # 1203
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City | CHICAGO
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State | IL
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Zip | 60640-4620
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Country | US
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Telephone | 312-278-7628
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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 | 221700000X
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Taxonomy Name | Art Therapist
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License Number | 178014741
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180014143
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License Number State | IL
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