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General NPI Number Information
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NPI Number | 1659687010
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Entity Type | Organization
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Legal Business Name | UNITY COUNSELING CENTER
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Dates
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Enumeration Date | 08/24/2010
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Last Update Date | 09/08/2010
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Provider Practice Location Address
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Address Line | 5870 W. LAKE STREET
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City | CHICAGO
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State | IL
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Zip | 60644-3888
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Country | US
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Telephone | 773-261-0324
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Fax | 708-450-1713
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Provider Business Mailing Address
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Address Line | 5870 W. LAKE STREET
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City | CHICAGO
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State | IL
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Zip | 60644-3888
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Country | US
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Telephone | 773-261-0324
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Fax | 708-450-1713
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Authorized Official
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Title or Position | PROGRAM COORDINATOR
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Name | MISS DARLINE ANITA HENDERSON
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Credential | MHP
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Telephone | 708-450-1707
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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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