| Transformative Psychotherapy Llc | |
|
4753 N Broadway St 830 Chicago IL 60640-5266 | |
| (773) 484-5186 | |
| Not Available |
| Full Name | Transformative Psychotherapy Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 4753 N Broadway St, Chicago, Illinois |
| Authorized Official Name and Position | Lisa J. Rivitz (MANAGER) |
| Authorized Official Contact | 7734845186 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Transformative Psychotherapy Llc 950 W Leland Ave #310 Chicago IL 60640-7100 Ph: (773) 484-5186 | Transformative Psychotherapy Llc 4753 N Broadway St 830 Chicago IL 60640-5266 Ph: (773) 484-5186 |
| NPI Number | 1063847622 |
|---|---|
| Provider Enumeration Date | 09/13/2013 |
| Last Update Date | 09/17/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063847622 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149002037 (Illinois) | Primary |
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