MEDICARE: INTEGRATIVE PERSPECTIVES COUNSELING AND CONSULTING PC

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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1861033268
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATIVE PERSPECTIVES COUNSELING AND CONSULTING PC

Provider Business Mailing Address
First Line	:	2109 W IRVING PARK RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-3923
Country	:	US
Telephone Number	:	312-544-9343
Fax Number	:	312-253-1404

Provider Business Practice Location Address
First Line	:	2109 W IRVING PARK RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-3923
Country	:	US
Telephone Number	:	312-544-9343
Fax Number	:	312-253-1404

Authorized Official
Title or Position	:	OWNER
Name	:	VERONICA URSETTO
Credential	:	MA LCPC
Telephone Number	:	312-544-9343

Provider Enumeration Date	:	10/07/2019
Last Update Date	:	10/07/2019

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