Provider Demographics
NPI:1952849564
Name:REBECCA HUBBARD DBA GROUNDED POWER PSYCHOLOGICAL CONSULTING
Entity Type:Organization
Organization Name:REBECCA HUBBARD DBA GROUNDED POWER PSYCHOLOGICAL CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUBBARD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:773-888-3361
Mailing Address - Street 1:1525 E 53RD ST
Mailing Address - Street 2:SUITE 501
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-4557
Mailing Address - Country:US
Mailing Address - Phone:773-888-3361
Mailing Address - Fax:773-897-5766
Practice Address - Street 1:1525 E 53RD ST
Practice Address - Street 2:SUITE 501
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-4557
Practice Address - Country:US
Practice Address - Phone:773-888-3361
Practice Address - Fax:773-897-5766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-02
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071009146103TC0700X
IL1490168761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty