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NPI 1700603842

NPI 1700603842 : POMEGRANATE HEALING PLLC : CHICAGO, IL

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General NPI Number Information
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    NPI Number           |    1700603842
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    Entity Type          |    Organization 
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    Legal Business Name  |    POMEGRANATE HEALING PLLC 
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Dates
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    Enumeration Date     |    09/20/2024
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    Last Update Date     |    09/20/2024
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Provider Practice Location Address
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    Address Line         |    3574 W MCLEAN AVE APT 2 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60647-7668
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    Country              |    US
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    Telephone            |    773-809-3493
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 47085 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60647-0001
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    Country              |    US
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    Telephone            |    773-809-3493
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    Fax                  |    
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Authorized Official
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    Title or Position    |    FOUNDER
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    Name                 |     FINLAY  SARAFA MCHALE 
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    Credential           |    LCSW
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    Telephone            |    773-809-3493
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    
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    License Number State |    
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