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General NPI Number Information
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NPI Number | 1902415854
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Entity Type | Organization
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Legal Business Name | ENRICHED LIVING COUNSELING LLC
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Dates
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Enumeration Date | 07/27/2020
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Last Update Date | 07/27/2020
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Provider Practice Location Address
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Address Line | 1546 W SHERWIN AVE APT 1S
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City | CHICAGO
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State | IL
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Zip | 60626-2138
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Country | US
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Telephone | 513-262-1680
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 60472
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City | CHICAGO
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State | IL
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Zip | 60660-0472
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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 | MARRIAGE AND FAMILY THERAPIST
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Name | FARRAH WALKER
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Credential | LMFT
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Telephone | 847-780-6023
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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