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General NPI Number Information
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NPI Number | 1639848567
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Entity Type | Organization
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Legal Business Name | SPRING ADVISORY PLLC
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Dates
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Enumeration Date | 09/13/2021
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Last Update Date | 09/13/2021
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Provider Practice Location Address
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Address Line | 3501 N SOUTHPORT AVE # 300
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City | CHICAGO
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State | IL
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Zip | 60657-1475
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Country | US
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Telephone | 312-380-1713
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Fax |
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Provider Business Mailing Address
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Address Line | 3501 N SOUTHPORT AVE # 300
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City | CHICAGO
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State | IL
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Zip | 60657-1475
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Country | US
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Telephone | 312-380-1713
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MS. SHAN RU LIN
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Credential | LCPC ATRBC ATCS
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Telephone | 609-529-0708
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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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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