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General NPI Number Information
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NPI Number | 1861244287
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Entity Type | Organization
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Legal Business Name | CANELA PSYCHOTHERAPY CHICAGO
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Dates
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Enumeration Date | 04/02/2024
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Last Update Date | 09/10/2024
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Provider Practice Location Address
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Address Line | 3057 N ROCKWELL ST STE 261
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City | CHICAGO
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State | IL
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Zip | 60618-7917
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Country | US
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Telephone | 224-319-4076
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Fax |
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Provider Business Mailing Address
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Address Line | 3057 N ROCKWELL ST STE 261
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City | CHICAGO
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State | IL
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Zip | 60618-7917
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Country | US
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Telephone | 224-319-4076
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL PSYCHOLOGICAL
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Name | DR. NATHALIE R HENAINE
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Credential | M.A., PSYD
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Telephone | 224-319-4076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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