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General NPI Number Information
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NPI Number | 1487891198
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Entity Type | Organization
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Legal Business Name | MENTAL HEALTH SOLUTIONS, P.C.
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Dates
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Enumeration Date | 01/16/2009
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Last Update Date | 01/16/2009
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Provider Practice Location Address
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Address Line | 101 LIONS DR SUITE 115
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City | BARRINGTON
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State | IL
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Zip | 60010-3181
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Country | US
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Telephone | 847-566-0164
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Fax | 847-277-7235
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Provider Business Mailing Address
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Address Line | 101 LIONS DR SUITE 115
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City | BARRINGTON
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State | IL
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Zip | 60010-3181
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Country | US
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Telephone | 847-566-0164
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Fax | 847-277-7235
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRIGHT-PROPHET ETERNITY FELLOWES
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Credential | PSY.D., LP
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Telephone | 847-566-0164
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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 | 071007152
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License Number State | IL
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