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General NPI Number Information
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NPI Number | 1811695489
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Entity Type | Organization
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Legal Business Name | CONNECT WITHIN, PLLC
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Dates
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Enumeration Date | 02/22/2023
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Last Update Date | 02/22/2023
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Provider Practice Location Address
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Address Line | 77 W WASHINGTON ST STE 1910
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City | CHICAGO
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State | IL
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Zip | 60602-3176
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Country | US
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Telephone | 402-547-3301
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Fax |
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Provider Business Mailing Address
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Address Line | 21 E HURON ST APT 2102
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City | CHICAGO
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State | IL
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Zip | 60611-3876
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Country | US
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Telephone | 402-547-3301
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LAUREN DAVIS
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Credential | LCSW
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Telephone | 402-547-3301
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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 |
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