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General NPI Number Information
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NPI Number | 1710226261
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Entity Type | Organization
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Legal Business Name | MELINDA LUPFER YACHNIN LCPC INC.
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Dates
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Enumeration Date | 02/04/2013
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Last Update Date | 02/04/2013
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Provider Practice Location Address
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Address Line | 72 S LA GRANGE RD STE 6
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City | LA GRANGE
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State | IL
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Zip | 60525-6318
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Country | US
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Telephone | 312-409-4960
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Fax |
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Provider Business Mailing Address
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Address Line | 72 S LA GRANGE RD STE 6
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City | LA GRANGE
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State | IL
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Zip | 60525-6318
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Country | US
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Telephone | 312-409-4960
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. MELINDA LUPFER YACHNIN
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Credential | MA
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Telephone | 312-409-4960
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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 | 180005280
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License Number State | IL
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