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General NPI Number Information
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NPI Number | 1497066898
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Entity Type | Organization
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Legal Business Name | LIFE PATH GUIDANCE, INC.
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Dates
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Enumeration Date | 06/30/2010
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Last Update Date | 06/30/2010
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Provider Practice Location Address
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Address Line | 8 S MICHIGAN AVE SUITE 1500
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City | CHICAGO
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State | IL
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Zip | 60603-3357
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Country | US
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Telephone | 312-630-9663
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Fax | 773-538-5321
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Provider Business Mailing Address
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Address Line | 8 S MICHIGAN AVE SUITE 1500
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City | CHICAGO
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State | IL
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Zip | 60603-3357
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Country | US
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Telephone | 312-630-9663
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Fax | 773-538-5321
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. MARY JEAN SELBY
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Credential | L.C.P.C.
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Telephone | 312-630-9663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180004609
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License Number State | IL
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