Provider Demographics
NPI:1942969738
Name:TMC THERAPY, PLLC
Entity Type:Organization
Organization Name:TMC THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THEODORA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLAIN-COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:708-408-2048
Mailing Address - Street 1:215 PIN OAK DR
Mailing Address - Street 2:
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-3128
Mailing Address - Country:US
Mailing Address - Phone:708-408-2048
Mailing Address - Fax:
Practice Address - Street 1:1818 DEMPSTER ST
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-1003
Practice Address - Country:US
Practice Address - Phone:708-408-2048
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-09
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty