NPI 1003868472 · live from the CMS NPI Registry
Affiliates In Counseling LLC
Psychologist, Clinical in Northbrook, IL. National Provider Identifier 1003868472, active.
NPI record
| NPI | 1003868472 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Psychologist, Clinical 103TC0700X |
| Practice location | 633 Skokie Blvd, 260, Northbrook, IL 60062 |
| Practice phone | 847-480-0300 |
| Mailing address | 910 Skokie Blvd, 215, Northbrook, IL 60062 |
| Enumerated | May 16, 2006 |
| Last updated | April 27, 2011 |
| Authorized official | Morton Mirman, Partner |
| Other names | The Center For Divorce Recovery |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Social Worker, Clinical | 1041C0700X | — |
| Marriage & Family Therapist | 106H00000X | — |
| Psychologist, Clinical primary | 103TC0700X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.