Fermata Psychotherapy, P.c. | |
53 W Jackson Blvd Ste 1632 Chicago IL 60604-3734 | |
(312) 725-6192 | |
Not Available |
Full Name | Fermata Psychotherapy, P.c. |
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Speciality | Social Worker - Clinical |
Location | 53 W Jackson Blvd Ste 1632, Chicago, Illinois |
Authorized Official Name and Position | Santiago Delboy (PRESIDENT) |
Authorized Official Contact | 3125206096 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Fermata Psychotherapy, P.c. 53 W Jackson Blvd Ste 1632 Chicago IL 60604-3734 Ph: (312) 520-6096 | Fermata Psychotherapy, P.c. 53 W Jackson Blvd Ste 1632 Chicago IL 60604-3734 Ph: (312) 725-6192 |
NPI Number | 1669964482 |
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Provider Enumeration Date | 06/06/2018 |
Last Update Date | 02/20/2024 |
Certification Date | 02/20/2024 |
Identifier | Type | State | Issuer |
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1669964482 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 149.019286 (Illinois) | Primary |
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