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General NPI Number Information
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NPI Number | 1700518529
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Entity Type | Individual
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Provider Name | JODEE ELLIOT LCPC
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Gender | Female
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Dates
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Enumeration Date | 06/29/2022
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Last Update Date | 06/29/2022
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Provider Practice Location Address
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Address Line | 20 N CLARK ST STE 2650
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City | CHICAGO
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State | IL
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Zip | 60602-5104
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Country | US
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Telephone | 877-416-3917
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Fax |
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Provider Business Mailing Address
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Address Line | 703 OGDEN AVE
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City | WESTERN SPRINGS
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State | IL
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Zip | 60558-1153
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Country | US
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Telephone | 504-494-0733
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Fax |
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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 | 180010126
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License Number State | IL
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