Provider Demographics
NPI:1235642596
Name:TREECE AND ASSOCIATES PSYCHOTHERAPY AND COUNSELING
Entity Type:Organization
Organization Name:TREECE AND ASSOCIATES PSYCHOTHERAPY AND COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER, MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:TREECE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:615-948-8939
Mailing Address - Street 1:8921 POTTAWATTAMI DR
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1907
Mailing Address - Country:US
Mailing Address - Phone:615-948-8939
Mailing Address - Fax:
Practice Address - Street 1:688 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60642-5912
Practice Address - Country:US
Practice Address - Phone:615-948-8939
Practice Address - Fax:312-489-8293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-08
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000000OtherI DO NOT HAVE THIS NUMBER