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General NPI Number Information
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NPI Number | 1821984568
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Entity Type | Organization
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Legal Business Name | THE TRAUMA & ANXIETY PSYCHOLOGICAL SERVICES CLINIC
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Dates
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Enumeration Date | 06/17/2025
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 1114 W BALMORAL AVE APT 1E
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City | CHICAGO
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State | IL
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Zip | 60640-1720
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Country | US
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Telephone | 773-379-8129
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Fax |
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Provider Business Mailing Address
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Address Line | 2501 CHATHAM RD STE 8366
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City | SPRINGFIELD
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State | IL
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Zip | 62704-4188
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Country | US
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Telephone | 773-379-8129
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST & SOLE PROPRIETOR
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Name | DR. JEREMY SAENZ
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Credential | PH.D.
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Telephone | 773-379-8129
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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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 | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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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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