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General NPI Number Information
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NPI Number | 1720090780
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Entity Type | Organization
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Legal Business Name | ST JAMES CATHEDRAL COUNSELING CENTER
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 11/08/2007
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Provider Practice Location Address
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Address Line | 50 E WASHINGTON ST SUITE 301
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City | CHICAGO
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State | IL
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Zip | 60602-2152
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Country | US
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Telephone | 312-252-9500
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Fax | 312-337-9243
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Provider Business Mailing Address
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Address Line | 50 E WASHINGTON ST SUITE 301
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City | CHICAGO
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State | IL
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Zip | 60602-2152
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Country | US
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Telephone | 312-252-9500
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Fax | 312-337-9243
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | MS. LUCIE M. PREBEL
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Credential |
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Telephone | 312-337-5874
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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 | IL
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