Provider Demographics
NPI:1982321717
Name:BETTER SELF, LLC
Entity Type:Organization
Organization Name:BETTER SELF, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LACEY
Authorized Official - Middle Name:C
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:630-251-2387
Mailing Address - Street 1:122 W NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-4204
Mailing Address - Country:US
Mailing Address - Phone:630-251-2387
Mailing Address - Fax:
Practice Address - Street 1:30 E HURON ST APT 908
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2784
Practice Address - Country:US
Practice Address - Phone:630-251-2387
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health