Center For Grief And Traumatic Loss, Llc in Libertyville - Clinical
Center For Grief And Traumatic Loss, Llc - NPI 1366655813
Center For Grief And Traumatic Loss, Llc is a Clinical in Libertyville, Illinois. Center For Grief And Traumatic Loss, Llc practices all healthcare services and medical treatments related to Clinical. The NPI Number for Center For Grief And Traumatic Loss, Llc is 1366655813. The last update date is 2020-08-22.
Center For Grief And Traumatic Loss, Llc's current location address is 1144 Harms Ave, Libertyville, Illinois. You can contact this provider via phone number 8476800279. The mailing address for Center For Grief And Traumatic Loss, Llc is 1144 Harms Ave, Libertyville, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Center For Grief And Traumatic Loss, Llc |
|---|---|
| Address | 1144 Harms Ave, Libertyville, Illinois |
| Phone Number | 8476800279 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | DIRECTOR |
|---|---|
| Authorized Official Name | Botkin L. Allan |
| Credentials | PSY.D. |
| Telephone Number | 8476800279 |
NPI Number Detail
| NPI Number | 1366655813 |
|---|---|
| Provider Enumeration Date | 2007-05-08 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 1144 Harms Ave |
|---|---|
| City | Libertyville |
| State | Illinois (IL) |
| Post Code | 600482524 |
| Phone Number | 8476800279 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Center For Grief And Traumatic Loss, Llc by the Centers for Medicare & Medicaid Services?
The Center For Grief And Traumatic Loss, Llc has been issued the NPI (National Provider Identifier) 1366655813, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Center For Grief And Traumatic Loss, Llc's physical address?
The Center For Grief And Traumatic Loss, Llc is physically located at 1144 Harms Ave, in the city of Libertyville, IL, with the postal code 600482524.
What is the Center For Grief And Traumatic Loss, Llc's specialty and taxonomy code?
The Center For Grief And Traumatic Loss, Llc's specialty is Clinical, and the corresponding taxonomy code is 103Tc0700X.
On what date did the Centers for Medicare & Medicaid Services assign the 1366655813 to Center For Grief And Traumatic Loss, Llc?
The Centers for Medicare & Medicaid Services assigned the 1366655813 to Center For Grief And Traumatic Loss, Llc on 2007-05-08.
As of what date was the information pertaining to Center For Grief And Traumatic Loss, Llc, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Center For Grief And Traumatic Loss, Llc, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2020-08-22.
NPI Number: 1932102142
Address: St. Jude Children's Research Hospital, Memphis, TN