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General NPI Number Information
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NPI Number | 1568052660
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Entity Type | Organization
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Legal Business Name | HOPE AND HEALING CENTER, LLC
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Dates
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Enumeration Date | 01/22/2021
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Last Update Date | 01/22/2021
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Provider Practice Location Address
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Address Line | 10725 S WESTERN AVE
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City | CHICAGO
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State | IL
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Zip | 60643-3217
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Country | US
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Telephone | 773-217-9368
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Fax |
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Provider Business Mailing Address
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Address Line | 6631 S RACINE AVE UNIT 2
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City | CHICAGO
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State | IL
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Zip | 60636-2909
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Country | US
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Telephone | 773-217-9368
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | PAMELA K WILLIAMS
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Credential | LCPC
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Telephone | 773-217-9368
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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 |
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License Number State |
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