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General NPI Number Information
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NPI Number | 1942965074
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Entity Type | Organization
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Legal Business Name | CREATE BALANCE COUNSELING, PLLC
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Dates
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Enumeration Date | 11/03/2021
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Last Update Date | 10/30/2022
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Provider Practice Location Address
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Address Line | 1224 ROBINHOOD LN
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City | LA GRANGE PARK
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State | IL
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Zip | 60526-5313
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Country | US
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Telephone | 773-919-3746
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Fax |
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Provider Business Mailing Address
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Address Line | 1224 ROBINHOOD LN
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City | LA GRANGE PARK
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State | IL
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Zip | 60526-5313
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Country | US
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Telephone | 773-919-3746
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ERIN MOONEY-SIMKUS
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Credential | LCPC, ATR-BC
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Telephone | 773-919-3746
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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 |
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License Number State |
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