| Modern Soul Therapy Llc | |
|
2000 N Racine Ave Ste 2160 Chicago IL 60614-4045 | |
| (740) 408-6407 | |
| Not Available |
| Full Name | Modern Soul Therapy Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2000 N Racine Ave Ste 2160, Chicago, Illinois |
| Authorized Official Name and Position | Mallory A Ingram (THERAPIST) |
| Authorized Official Contact | 7404086407 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Soul Therapy Llc 375 Market St Unit 304 Brighton MA 02135-2754 Ph: (740) 408-6407 | Modern Soul Therapy Llc 2000 N Racine Ave Ste 2160 Chicago IL 60614-4045 Ph: (740) 408-6407 |
| NPI Number | 1013516145 |
|---|---|
| Provider Enumeration Date | 10/20/2020 |
| Last Update Date | 10/20/2020 |
| Certification Date | 10/20/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013516145 | NPI | - | NPPES |
| 09322531 | Other | PRIVATE INSURANCE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Philip K Mccullough Md Sc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 E Huron St, Suite 11-100, Chicago, IL 60611 Phone: 312-695-3680 Fax: 312-926-3709 | |
Amy Lynn, Lcpc, Atr Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3020 N Lincoln Ave, Flourish Studios, Chicago, IL 60657 Phone: 773-746-7429 | |
K.a.m Alliance, Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2215 W 95th St Ste 100, Chicago, IL 60643 Phone: 773-239-9600 Fax: 773-239-9601 | |
King Community Mental Health Center Corp Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4455 S King Drive, Suite 101, Chicago, IL 60653 Phone: 773-536-2700 Fax: 773-751-2250 | |
Young Adult Program Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4219 N Lincoln Ave, Chicago, IL 60618 Phone: 773-572-5500 Fax: 773-537-3488 | |
Professional Diagnostic Service, S.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 821 W Van Buren St, Chicago, IL 60607 Phone: 312-491-0404 Fax: 312-491-0505 | |
Universal Medical Group Ltd. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 809 E 42nd Pl, Chicago, IL 60653 Phone: 773-285-3422 |