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General NPI Number Information
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NPI Number | 1669197380
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Entity Type | Organization
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Legal Business Name | SUCCEEDING WITH ADHD LLC
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Dates
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Enumeration Date | 10/05/2022
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Last Update Date | 10/05/2022
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Provider Practice Location Address
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Address Line | 700 S SPRING RD
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City | ELMHURST
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State | IL
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Zip | 60126-4253
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Country | US
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Telephone | 708-320-1547
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5761
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City | VILLA PARK
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State | IL
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Zip | 60181-5308
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Country | US
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Telephone | 708-320-1547
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | MS. ERIN E SERRANO
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Credential | LCSW
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Telephone | 708-320-1547
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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