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General NPI Number Information
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NPI Number | 1609975234
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Entity Type | Organization
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Legal Business Name | LAKE-COOK PSYCHOLOGISTS AND COUNSELING ASSOCIATES
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3285 N ARLINGTON HEIGHTS ROAD SUITE 201
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60004
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Country | US
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Telephone | 847-577-1501
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Fax | 847-577-3858
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Provider Business Mailing Address
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Address Line | 3285 N ARLINGTON HEIGHTS ROAD SUITE 201
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60004
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Country | US
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Telephone | 847-577-1501
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Fax | 847-577-3858
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Authorized Official
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Title or Position | DIRECTOR
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Name | SUSAN J MAYFIELD
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Credential | PHD
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Telephone | 847-577-1501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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