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General NPI Number Information
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NPI Number | 1952542524
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Entity Type | Individual
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Provider Name | BESS SURMENKOW LCPC
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Gender | Female
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Dates
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Enumeration Date | 03/11/2009
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Last Update Date | 03/11/2009
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Provider Practice Location Address
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Address Line | 3000 DUNDEE RD 411-412
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City | NORTHBROOK
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State | IL
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Zip | 60062-2422
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Country | US
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Telephone | 847-280-0686
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Fax |
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Provider Business Mailing Address
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Address Line | 9715 WOODS DR #704
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City | SKOKIE
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State | IL
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Zip | 60077-4438
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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 |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180006921
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License Number State | IL
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