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General NPI Number Information
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NPI Number | 1467852483
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Entity Type | Organization
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Legal Business Name | CHICAGO COUNSELING & TRAINING, INC
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Dates
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Enumeration Date | 08/27/2014
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Last Update Date | 11/10/2014
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Provider Practice Location Address
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Address Line | 4817 W. 83RD STREET BURBANK MEDICAL CENTER
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City | BURBANK
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State | IL
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Zip | 60459
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Country | US
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Telephone | 773-673-3702
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Fax |
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Provider Business Mailing Address
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Address Line | 4817 W. 83RD STREET
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City | BURBANK
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State | IL
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Zip | 60459
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Country | US
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Telephone | 773-673-3702
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Fax |
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Authorized Official
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Title or Position | THERAPIST/MANAGER
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Name | MRS. HOYAM HUSSIEN TANON
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Credential | MACC, QMQP
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Telephone | 773-673-3702
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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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