MEDICARE: PATHWAY TO HOPE THERAPEUTIC SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1831968361
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATHWAY TO HOPE THERAPEUTIC SERVICES

Provider Business Mailing Address
First Line	:	225 ROB ROY LN APT C
Second Line	:
City	:	PROSPECT HEIGHTS
State	:	IL
Zip	:	60070-2858
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	225 ROB ROY LN APT C
Second Line	:
City	:	PROSPECT HEIGHTS
State	:	IL
Zip	:	60070-2858
Country	:	US
Telephone Number	:	773-636-9357
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NICOLE LOCHIRCO
Credential	:	LCPC
Telephone Number	:	773-636-9357

Provider Enumeration Date	:	12/26/2023
Last Update Date	:	12/26/2023

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Directions to “PATHWAY TO HOPE THERAPEUTIC SERVICES ” Practice Location

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