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General NPI Number Information
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NPI Number | 1629828009
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Entity Type | Organization
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Legal Business Name | SOCIAL CONNECTION COUNSELING, PLLC
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Dates
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Enumeration Date | 03/26/2024
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Last Update Date | 04/07/2024
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Provider Practice Location Address
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Address Line | 661 W LAKE ST STE 2S
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City | CHICAGO
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State | IL
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Zip | 60661-1034
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Country | US
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Telephone | 312-869-2891
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Fax |
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Provider Business Mailing Address
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Address Line | 661 W LAKE ST STE 2S
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City | CHICAGO
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State | IL
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Zip | 60661-1034
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Country | US
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Telephone | 312-869-2891
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Fax |
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Authorized Official
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Title or Position | OWNER & PSYCHOTHERAPIST
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Name | JOHN CHRISTOPHER WILLIAMS
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Credential | L.C.P.C.
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Telephone | 312-869-2891
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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