Provider Demographics
NPI:1720851678
Name:SINANE GOULET LCSW PLLC
Entity Type:Organization
Organization Name:SINANE GOULET LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SINANE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOULET
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:773-742-6824
Mailing Address - Street 1:2132 W ROSCOE ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-6241
Mailing Address - Country:US
Mailing Address - Phone:773-742-6824
Mailing Address - Fax:
Practice Address - Street 1:2132 W ROSCOE ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-6241
Practice Address - Country:US
Practice Address - Phone:773-742-6824
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)