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General NPI Number Information
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NPI Number | 1871276402
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Entity Type | Organization
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Legal Business Name | WELSH COUNSELING & COACHING INC.
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Dates
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Enumeration Date | 08/10/2023
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Last Update Date | 08/10/2023
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Provider Practice Location Address
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Address Line | 709 CHICAGO AVE
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City | EVANSTON
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State | IL
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Zip | 60202-2310
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Country | US
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Telephone | 317-694-8282
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8151
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City | EVANSTON
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State | IL
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Zip | 60204-8151
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Country | US
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Telephone | 317-694-8282
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MATT WELSH
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Credential | PHD
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Telephone | 317-694-8282
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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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