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General NPI Number Information
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NPI Number | 1689030603
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Entity Type | Organization
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Legal Business Name | KATHLEEN R. BRENNAN, INC.
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Dates
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Enumeration Date | 01/06/2016
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Last Update Date | 01/06/2016
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Provider Practice Location Address
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Address Line | 3139 N LINCOLN AVE
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City | CHICAGO
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State | IL
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Zip | 60657-3114
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Country | US
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Telephone | 847-975-9883
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Fax |
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Provider Business Mailing Address
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Address Line | 3139 N LINCOLN AVE
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City | CHICAGO
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State | IL
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Zip | 60657-3114
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | KATHLEEN R. BRENNAN
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Credential |
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Telephone | 847-975-9883
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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 | 180007611
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License Number State | IL
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