Provider Demographics
NPI:1376262642
Name:CEM MENTAL HEALTHCARE & COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:CEM MENTAL HEALTHCARE & COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESICENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AUGUSTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LANSANA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:412-853-2586
Mailing Address - Street 1:6236 N HOYNE AVENUE
Mailing Address - Street 2:APT AB
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659
Mailing Address - Country:US
Mailing Address - Phone:412-853-2586
Mailing Address - Fax:
Practice Address - Street 1:5447 W. ADDISON STREET
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641
Practice Address - Country:US
Practice Address - Phone:412-853-2586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CEM MISSIONS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty