Provider Demographics
NPI:1679294995
Name:MODERN COMPASSIONATE COUNSELING
Entity Type:Organization
Organization Name:MODERN COMPASSIONATE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:LUPO
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:847-736-7947
Mailing Address - Street 1:8501 W HIGGINS RD STE 601
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-2816
Mailing Address - Country:US
Mailing Address - Phone:773-644-5535
Mailing Address - Fax:
Practice Address - Street 1:8501 W HIGGINS RD STE 601
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-2816
Practice Address - Country:US
Practice Address - Phone:773-644-5535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)