Provider Demographics
NPI:1710589403
Name:CHARISMA THERAPY ASSOCIATES P LLC
Entity Type:Organization
Organization Name:CHARISMA THERAPY ASSOCIATES P LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:708-539-5312
Mailing Address - Street 1:3518 BIRCHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HAZEL CREST
Mailing Address - State:IL
Mailing Address - Zip Code:60429-1039
Mailing Address - Country:US
Mailing Address - Phone:708-539-5312
Mailing Address - Fax:
Practice Address - Street 1:19624 GOVERNORS HWY STE 1
Practice Address - Street 2:
Practice Address - City:FLOSSMOOR
Practice Address - State:IL
Practice Address - Zip Code:60422-2086
Practice Address - Country:US
Practice Address - Phone:708-816-4577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health