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General NPI Number Information
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NPI Number | 1538934021
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Entity Type | Organization
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Legal Business Name | CHICAGO ANXIETY COUNSELING, SUPERVISION, AND CONSULTATION INC
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Dates
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Enumeration Date | 11/15/2023
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Last Update Date | 11/15/2023
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Provider Practice Location Address
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Address Line | 655 W IRVING PARK RD STE 202
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City | CHICAGO
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State | IL
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Zip | 60613-4932
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Country | US
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Telephone | 872-529-1980
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Fax |
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Provider Business Mailing Address
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Address Line | 3950 N LAKE SHORE DR UNIT 205A
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City | CHICAGO
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State | IL
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Zip | 60613-3434
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Country | US
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Telephone | 313-655-0351
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SONILA SEJDARAS
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Credential | PSYD
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Telephone | 313-655-0351
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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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