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General NPI Number Information
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NPI Number | 1689797276
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Entity Type | Organization
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Legal Business Name | OF SOUND MIND, INC.
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5215 N RAVENSWOOD AVE SUITE 214
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City | CHICAGO
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State | IL
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Zip | 60640-1668
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Country | US
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Telephone | 773-907-8825
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Fax | 773-907-8841
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Provider Business Mailing Address
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Address Line | 5215 N RAVENSWOOD AVE SUITE 214
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City | CHICAGO
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State | IL
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Zip | 60640-1668
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Country | US
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Telephone | 773-907-8825
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Fax | 773-907-8841
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. LORI R GRIFO
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Credential | PSY.D.
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Telephone | 773-907-8825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State | IL
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