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General NPI Number Information
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NPI Number | 1932734548
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Entity Type | Organization
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Legal Business Name | KEYS TO CARE PSYCHOLOGICAL SERVICES, LLC
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Dates
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Enumeration Date | 03/04/2020
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Last Update Date | 03/04/2020
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Provider Practice Location Address
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Address Line | 325 N WELLS ST
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City | CHICAGO
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State | IL
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Zip | 60654-7024
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Country | US
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Telephone | 312-467-2506
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Fax |
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Provider Business Mailing Address
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Address Line | 901 LAKE ST # 2027
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City | OAK PARK
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State | IL
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Zip | 60301-1286
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Country | US
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Telephone | 312-772-3678
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST/OWNER
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Name | DR. KEESHAWNA BROOKS
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Credential | PHD, NCSP, LP
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Telephone | 312-772-3678
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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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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