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General NPI Number Information
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NPI Number | 1801596465
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Entity Type | Organization
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Legal Business Name | LIVENLEARN, LLC
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Dates
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Enumeration Date | 03/03/2023
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 1761 N DILLEYS RD STE 112
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City | GURNEE
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State | IL
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Zip | 60031-1711
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Country | US
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Telephone | 847-226-6213
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Fax | 847-379-5512
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Provider Business Mailing Address
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Address Line | 1761 N DILLEYS RD STE 112
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City | GURNEE
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State | IL
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Zip | 60031-1711
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMY SLUTZKY
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Credential | LCPC
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Telephone | 847-226-6213
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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 |
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License Number State |
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