Provider Demographics
NPI:1841749348
Name:TAO, MINNIE ZHICHEN (LPC)
Entity Type:Individual
Prefix:
First Name:MINNIE
Middle Name:ZHICHEN
Last Name:TAO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6224 N BROADWAY ST
Mailing Address - Street 2:APT 3
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-1903
Mailing Address - Country:US
Mailing Address - Phone:214-793-3855
Mailing Address - Fax:
Practice Address - Street 1:6224 N BROADWAY ST
Practice Address - Street 2:APT 3
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60660-1903
Practice Address - Country:US
Practice Address - Phone:214-793-3855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-25
Last Update Date:2016-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.012327101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL178.012327OtherLICENSED PROFESSIONAL COUNSELOR WITH IDFPR