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General NPI Number Information
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NPI Number | 1902391907
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Entity Type | Organization
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Legal Business Name | STRIDE COUNSELING, LLC
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Dates
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Enumeration Date | 06/22/2018
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Last Update Date | 11/24/2020
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Provider Practice Location Address
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Address Line | 333 N MICHIGAN AVE STE 1828
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City | CHICAGO
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State | IL
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Zip | 60601-4108
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Country | US
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Telephone | 773-769-7255
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Fax |
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Provider Business Mailing Address
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Address Line | 5646 N GLENWOOD AVE APT 2N
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City | CHICAGO
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State | IL
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Zip | 60660-4563
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Country | US
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Telephone | 773-769-7255
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | KHOSHNAM ABDUL HAMID
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Credential | LCPC
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Telephone | 773-793-4766
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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 | 180.011608
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License Number State | IL
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