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General NPI Number Information
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NPI Number | 1467838276
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Entity Type | Organization
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Legal Business Name | ENLIVEN COUPLES THERAPY, INC.
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Dates
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Enumeration Date | 08/04/2015
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Last Update Date | 08/04/2015
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Provider Practice Location Address
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Address Line | 25 E WASHINGTON ST SUITE 1725
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City | CHICAGO
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State | IL
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Zip | 60602-1708
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Country | US
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Telephone | 312-448-6303
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Fax |
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Provider Business Mailing Address
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Address Line | 25 E WASHINGTON ST SUITE 1725
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City | CHICAGO
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State | IL
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Zip | 60602-1708
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Country | US
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Telephone | 312-448-6303
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Fax |
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Authorized Official
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Title or Position | FOUNDER AND CLINICAL DIRECTOR
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Name | KIMBERLY SHARKEY
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Credential |
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Telephone | 773-469-1507
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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