Provider Demographics
NPI:1578333902
Name:INNER CHOICE PSYCHOTHERAPY
Entity Type:Organization
Organization Name:INNER CHOICE PSYCHOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ANNABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHICKERING
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:312-806-8854
Mailing Address - Street 1:5547 N RAVENSWOOD AVE STE 407
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-1125
Mailing Address - Country:US
Mailing Address - Phone:312-806-8854
Mailing Address - Fax:
Practice Address - Street 1:5547 N RAVENSWOOD AVE STE 407
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-1125
Practice Address - Country:US
Practice Address - Phone:312-806-8854
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-08
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty