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General NPI Number Information
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NPI Number | 1609310523
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Entity Type | Organization
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Legal Business Name | KARI SANDY COUNSELING CORPORATION
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Dates
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Enumeration Date | 12/12/2016
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Last Update Date | 03/07/2017
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Provider Practice Location Address
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Address Line | 975 E NERGE RD SUITE W100-E
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City | ROSELLE
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State | IL
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Zip | 60172-4804
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Country | US
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Telephone | 773-263-7796
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Fax |
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Provider Business Mailing Address
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Address Line | 556 LINCOLN ST
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City | ROSELLE
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State | IL
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Zip | 60172-1003
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Country | US
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Telephone | 773-263-7796
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. KARI SANDY
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Credential | LCSW
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Telephone | 773-263-7796
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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 | 149013042
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License Number State | IL
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