| North Shore Counseling Services, Llc. | |
|
480 Elm Pl Highland Park IL 60035-2538 | |
| (847) 234-4015 | |
| (847) 234-4015 |
| Full Name | North Shore Counseling Services, Llc. |
|---|---|
| Speciality | Psychologist |
| Location | 480 Elm Pl, Highland Park, Illinois |
| Authorized Official Name and Position | Susanne Elizabeth Richter (LICENSED CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 8472344015 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Shore Counseling Services, Llc. 480 Elm Pl Ste 104 Highland Park IL 60035-2535 Ph: (847) 234-4015 | North Shore Counseling Services, Llc. 480 Elm Pl Highland Park IL 60035-2538 Ph: (847) 234-4015 |
| NPI Number | 1972825164 |
|---|---|
| Provider Enumeration Date | 02/16/2010 |
| Last Update Date | 09/06/2012 |
| Medicare PECOS PAC ID | 8123152014 |
|---|---|
| Medicare Enrollment ID | O20100813000679 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972825164 | NPI | - | NPPES |
| 1972666709 | Other | IL | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 071006792 (Illinois) | Primary |
| Provider Name | Susanne E Richter |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1972666709 PECOS PAC ID: 9830223734 Enrollment ID: I20100816000958 |
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