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General NPI Number Information
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NPI Number | 1629813084
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Entity Type | Organization
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Legal Business Name | BODYUP COUNSELING LLC
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Dates
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Enumeration Date | 06/27/2024
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 5320 N SHERIDAN RD APT 1310
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City | CHICAGO
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State | IL
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Zip | 60640-2543
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Country | US
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Telephone | 872-366-1474
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Fax |
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Provider Business Mailing Address
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Address Line | 1205 W SHERWIN AVE APT 704
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City | CHICAGO
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State | IL
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Zip | 60626-2291
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | THOMAS NIMROD
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Credential | LCPC
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Telephone | 872-366-1474
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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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