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General NPI Number Information
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NPI Number | 1790342848
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Entity Type | Organization
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Legal Business Name | SETO PSYCHOLOGY LLC
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Dates
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Enumeration Date | 05/23/2019
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Last Update Date | 09/17/2020
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Provider Practice Location Address
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Address Line | 180 N MICHIGAN AVE STE 1025G
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City | CHICAGO
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State | IL
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Zip | 60601-7999
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Country | US
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Telephone | 312-281-8874
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Fax |
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Provider Business Mailing Address
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Address Line | 161 W HARRISON ST UNIT 1007
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City | CHICAGO
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State | IL
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Zip | 60605-1080
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Country | US
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Telephone | 646-642-4979
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | ERIC SETO
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Credential | PSYD
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Telephone | 312-281-8874
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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