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General NPI Number Information
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NPI Number | 1861977456
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Entity Type | Organization
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Legal Business Name | VIRTUE COUNSELING CENTER
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Dates
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Enumeration Date | 09/28/2018
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Last Update Date | 09/28/2018
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Provider Practice Location Address
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Address Line | 2904 N PARKSIDE
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City | CHICAGO
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State | IL
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Zip | 60634
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Country | US
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Telephone | 773-710-6315
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Fax |
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Provider Business Mailing Address
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Address Line | 2904 N PARKSIDE AVE
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City | CHICAGO
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State | IL
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Zip | 60634-5320
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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 | DIRECTOR
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Name | MR. JOSE MIGUEL VIRUET
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Credential | LCPC. CRAC
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Telephone | 773-710-6315
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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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