Black Excellence Psychotherapy Pllc | |
30047 N Waukegan Rd Lake Bluff IL 60044-1023 | |
(718) 342-4986 | |
Not Available |
Full Name | Black Excellence Psychotherapy Pllc |
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Speciality | Clinic/center - Adolescent And Children Mental Health |
Location | 30047 N Waukegan Rd, Lake Bluff, Illinois |
Authorized Official Name and Position | Fitzgerald Ajoku (FOUNDER) |
Authorized Official Contact | 9146091183 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Black Excellence Psychotherapy Pllc 30047 N Waukegan Rd Lake Bluff IL 60044-1023 Ph: () - | Black Excellence Psychotherapy Pllc 30047 N Waukegan Rd Lake Bluff IL 60044-1023 Ph: (718) 342-4986 |
NPI Number | 1700539681 |
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Provider Enumeration Date | 01/31/2022 |
Last Update Date | 10/16/2022 |
Certification Date | 10/16/2022 |
Identifier | Type | State | Issuer |
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1700539681 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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