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General NPI Number Information
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NPI Number | 1487129870
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Entity Type | Organization
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Legal Business Name | STAR-STRESS, ANXIETY & RESILIENCE CONSULTANTS, LLC
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Dates
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Enumeration Date | 10/11/2018
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Last Update Date | 10/11/2018
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Provider Practice Location Address
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Address Line | 25 E WASHINGTON ST STE 1717
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City | CHICAGO
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State | IL
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Zip | 60602-1839
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Country | US
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Telephone | 216-402-3599
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 N LAKE SHORE PLZ APT 9B
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City | CHICAGO
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State | IL
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Zip | 60611-1200
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Country | US
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Telephone | 216-402-3599
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. STEVAN HOBFOLL
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Credential | PH.D.
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Telephone | 216-402-3599
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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