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General NPI Number Information
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NPI Number | 1508337999
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Entity Type | Individual
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Provider Name | FRANK MICHAEL CONGINE LCPC, LPC, CMHC
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Gender | Male
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Dates
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Enumeration Date | 12/10/2018
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Last Update Date | 12/10/2018
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Provider Practice Location Address
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Address Line | 70 W MADISON ST
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City | CHICAGO
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State | IL
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Zip | 60602-4252
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Country | US
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Telephone | 312-735-3220
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Fax |
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Provider Business Mailing Address
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Address Line | 1139 23RD ST
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City | MANHATTAN BEACH
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State | CA
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Zip | 90266-2927
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Country | US
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Telephone | 312-735-3320
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 180.009229
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC.0094986
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 11041667-6004
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License Number State | UT
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