Willoughby Center For Behavioral Health, Llc | |
1603 Orrington Ave. Ste. 600 Evanston IL 60201 | |
(224) 585-3312 | |
(224) 585-3619 |
Full Name | Willoughby Center For Behavioral Health, Llc |
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Speciality | Psychologist - Clinical |
Location | 1603 Orrington Ave., Evanston, Illinois |
Authorized Official Name and Position | Cindi-marie Willoughby (CLINICAL PSYCHOLOGIST) |
Authorized Official Contact | 7738141445 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Willoughby Center For Behavioral Health, Llc 1603 Orrington Ave Ste 600 Evanston IL 60201-3860 Ph: (224) 585-3312 | Willoughby Center For Behavioral Health, Llc 1603 Orrington Ave. Ste. 600 Evanston IL 60201 Ph: (224) 585-3312 |
NPI Number | 1700257581 |
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Provider Enumeration Date | 10/19/2015 |
Last Update Date | 04/15/2024 |
Certification Date | 04/15/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1700257581 | NPI | - | NPPES |
558816518-001 | Medicaid | IL | |
1487929345 | Other | IL | NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | 071.008303 (Illinois) | Primary |
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