Provider Demographics
NPI:1164814174
Name:THE CHICAGO SCHOOL OF PROFESSIONAL PSYCHOLOGY COUNSELING CENTERS
Entity Type:Organization
Organization Name:THE CHICAGO SCHOOL OF PROFESSIONAL PSYCHOLOGY COUNSELING CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AVP TRAINING AND LICENSURE AFFAIRS
Authorized Official - Prefix:DR
Authorized Official - First Name:DAUN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:310-481-5900
Mailing Address - Street 1:1990 WESTWOOD BLVD
Mailing Address - Street 2:SUITE 330
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-4650
Mailing Address - Country:US
Mailing Address - Phone:310-481-5900
Mailing Address - Fax:
Practice Address - Street 1:1990 WESTWOOD BLVD
Practice Address - Street 2:SUITE 330
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-4650
Practice Address - Country:US
Practice Address - Phone:310-481-5900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-27
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty