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General NPI Number Information
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NPI Number | 1659967909
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Entity Type | Organization
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Legal Business Name | CONNECTED PATHS COUNSELING PLLC
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Dates
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Enumeration Date | 12/20/2020
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Last Update Date | 01/10/2021
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Provider Practice Location Address
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Address Line | 351 W HUBBARD ST STE 210
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City | CHICAGO
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State | IL
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Zip | 60654-4493
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Country | US
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Telephone | 773-972-9145
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Fax |
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Provider Business Mailing Address
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Address Line | 5510 N KENMORE AVE APT 2A
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City | CHICAGO
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State | IL
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Zip | 60640-1537
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Country | US
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Telephone | 773-972-9145
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DARIA COOPER
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Credential | LCSW
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Telephone | 773-972-9145
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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