Provider Demographics
NPI:1912593377
Name:ISA'S CREATIVE COUNSELING
Entity Type:Organization
Organization Name:ISA'S CREATIVE COUNSELING
Other - Org Name:ISA CREATIVE COUNSELING
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ISABEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:MULCAHY
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:773-329-1499
Mailing Address - Street 1:2032 N OAK PARK AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60707-3344
Mailing Address - Country:US
Mailing Address - Phone:773-985-1303
Mailing Address - Fax:
Practice Address - Street 1:7518 MADISON ST
Practice Address - Street 2:
Practice Address - City:FOREST PARK
Practice Address - State:IL
Practice Address - Zip Code:60130-3500
Practice Address - Country:US
Practice Address - Phone:773-985-1303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-18
Last Update Date:2021-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL180.009014OtherLCPC LICENSE
IL180.009014OtherLCPC