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General NPI Number Information
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NPI Number | 1568740132
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Entity Type | Organization
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Legal Business Name | CENTER FOR THERAPEUTIC SERVICES & PSYCHODIAGNOSTICS
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Dates
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Enumeration Date | 07/29/2011
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Last Update Date | 06/01/2024
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Provider Practice Location Address
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Address Line | 618 S IL ROUTE 31 SUITE 2
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City | MCHENRY
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State | IL
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Zip | 60050-8273
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Country | US
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Telephone | 847-636-4070
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Fax |
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Provider Business Mailing Address
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Address Line | 618 S IL ROUTE 31 SUITE 2
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City | MCHENRY
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State | IL
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Zip | 60050-8273
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Country | US
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Telephone | 847-636-4070
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMANDA KARLEN
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Credential | LCPC
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Telephone | 847-636-4070
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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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