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General NPI Number Information
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NPI Number | 1750983607
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Entity Type | Organization
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Legal Business Name | THE CENTER FOR AFFIRMING FAMILIES, INC
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Dates
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Enumeration Date | 11/14/2020
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Last Update Date | 10/13/2021
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Provider Practice Location Address
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Address Line | 9504 S HAMILTON AVE # 8
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City | CHICAGO
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State | IL
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Zip | 60643-1120
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Country | US
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Telephone | 773-290-1228
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Fax |
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Provider Business Mailing Address
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Address Line | 9504 S HAMILTON AVE # 8
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City | CHICAGO
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State | IL
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Zip | 60643-1120
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Country | US
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Telephone | 773-290-1228
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KIRA E WEIDNER
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Credential | PSYD
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Telephone | 773-290-1228
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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