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General NPI Number Information
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NPI Number | 1902099781
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Entity Type | Individual
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Provider Name | LAURA J TEJADA LMFT, LCPC
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Gender | Female
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Dates
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Enumeration Date | 08/24/2007
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Last Update Date | 08/08/2023
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Provider Practice Location Address
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Address Line | 444 N MICHIGAN AVE STE 1200
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City | CHICAGO
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State | IL
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Zip | 60611-3959
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Country | US
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Telephone | 773-609-0622
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Fax |
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Provider Business Mailing Address
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Address Line | 444 N MICHIGAN AVE STE 1200
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City | CHICAGO
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State | IL
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Zip | 60611-3959
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Country | US
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Telephone | 773-609-0622
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC21485
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 180.008976
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LCPC300
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License Number State | KS
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT15847
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License Number State | AZ
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Taxonomy #5
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT1002
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License Number State | KS
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Taxonomy #6
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 166.000927
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License Number State | IL
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