Provider Demographics
NPI:1457016305
Name:CAREER AND WELLNESS CENTER, PLLC
Entity Type:Organization
Organization Name:CAREER AND WELLNESS CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:AUTUMN
Authorized Official - Middle Name:LARA
Authorized Official - Last Name:CABELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:872-215-2661
Mailing Address - Street 1:1444 W TAYLOR ST # 2654
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-4670
Mailing Address - Country:US
Mailing Address - Phone:872-215-2661
Mailing Address - Fax:
Practice Address - Street 1:1421 W HURON ST APT 2F
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60642-6128
Practice Address - Country:US
Practice Address - Phone:872-215-2661
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-05
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)