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General NPI Number Information
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NPI Number | 1609271030
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Entity Type | Organization
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Legal Business Name | Q PSYCH CONSULTING, LLC
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Dates
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Enumeration Date | 10/28/2014
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Last Update Date | 10/28/2014
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Provider Practice Location Address
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Address Line | 717 MAIN ST
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City | EVANSTON
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State | IL
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Zip | 60202-1701
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Country | US
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Telephone | 708-984-9342
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 613
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City | CHANNAHON
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State | IL
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Zip | 60410-0613
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Country | US
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Telephone | 815-521-1889
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Fax | 815-521-1889
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Authorized Official
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Title or Position | OWNER
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Name | DANIEL S BINAEI
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Credential | LCSW
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Telephone | 773-984-9342
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149013849
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License Number State | IL
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