Provider Demographics
NPI:1962827964
Name:OCHOA-GALINDO, CARMEN (EDD, LCPC)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:OCHOA-GALINDO
Suffix:
Gender:F
Credentials:EDD, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3030 N MOBILE AVE
Mailing Address - Street 2:PCC COMMUNITY WELLNESS CENTER
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-4041
Mailing Address - Country:US
Mailing Address - Phone:773-622-5679
Mailing Address - Fax:
Practice Address - Street 1:3030 N MOBILE AVE
Practice Address - Street 2:PCC COMMUNITY WELLNESS CENTER
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-4041
Practice Address - Country:US
Practice Address - Phone:773-622-5679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-27
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.008360101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional