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General NPI Number Information
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NPI Number | 1467344747
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Entity Type | Individual
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Provider Name | ISELA ESTRADA LCPC
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Gender | Female
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Dates
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Enumeration Date | 07/19/2025
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Last Update Date | 07/19/2025
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Provider Practice Location Address
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Address Line | 6442 W 64TH ST
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City | CHICAGO
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State | IL
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Zip | 60638-5008
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Country | US
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Telephone | 773-706-3700
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Fax |
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Provider Business Mailing Address
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Address Line | 6447 S KARLOV AVE
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City | CHICAGO
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State | IL
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Zip | 60629-5101
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Country | US
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Telephone | 773-706-3700
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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 | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | 2469162
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 225600000X
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Taxonomy Name | Dance Therapist
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License Number | R-DMT-1840
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 180.010132
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License Number State | IL
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