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General NPI Number Information
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NPI Number | 1679803936
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Entity Type | Individual
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Provider Name | JEANINE JENNIFER CANNELLA HOWE LCPC, CDVP
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Gender | Female
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Dates
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Enumeration Date | 01/10/2010
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Last Update Date | 10/03/2011
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Provider Practice Location Address
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Address Line | 3047 N LINCOLN AVE 400
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City | CHICAGO
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State | IL
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Zip | 60657-4999
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Country | US
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Telephone | 630-935-1501
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Fax |
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Provider Business Mailing Address
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Address Line | 3047 N LINCOLN AVE UNIT 400 3S
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City | CHICAGO
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State | IL
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Zip | 60657-4274
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Country | US
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Telephone | 630-935-1501
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Fax | 773-404-5837
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180005370
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License Number State | IL
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