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General NPI Number Information
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NPI Number | 1871310789
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Entity Type | Organization
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Legal Business Name | CONNECTED LIVING COUNSELING & THERAPEUTIC SERVICES, LLC
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Dates
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Enumeration Date | 09/23/2024
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 18220 HARWOOD AVE STE 5
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City | HOMEWOOD
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State | IL
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Zip | 60430-2151
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Country | US
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Telephone | 708-365-6501
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Fax | 708-844-0978
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Provider Business Mailing Address
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Address Line | 18220 HARWOOD AVE STE 5
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City | HOMEWOOD
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State | IL
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Zip | 60430-2151
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Country | US
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Telephone | 708-365-6501
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Fax | 708-844-0978
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Authorized Official
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Title or Position | OWNER, CLINICAL DIRECTOR
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Name | DR. SHOSHANAH YEHUDAH
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Credential | LCPC
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Telephone | 708-395-6083
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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