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General NPI Number Information
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NPI Number | 1831430719
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Entity Type | Individual
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Provider Name | MARIA GOVEA LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/02/2013
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Last Update Date | 03/02/2013
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Provider Practice Location Address
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Address Line | 1731 N MARCEY ST 535
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City | CHICAGO
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State | IL
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Zip | 60614-5373
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Country | US
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Telephone | 312-280-1166
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Fax |
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Provider Business Mailing Address
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Address Line | 2652 W RASCHER AVE 2652 W RASCHER
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City | CHICAGO
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State | IL
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Zip | 60625-3141
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Country | US
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Telephone | 773-319-9630
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 149014764
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License Number State | IL
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