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Organization
SPROUT VENTURES, INC.
Active
Organization
SPROUT VENTURES, INC.
Active
Other names
Sprout Clinics
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHAN MATTHEW GOMBIS MSMFT, LCPC, BCN (EXECUTIVE DIRECTOR)
(312) 794-5582
Entity
Organization
Contact information
Practice address
221 E CULLERTON ST, UNIT 101A, CHICAGO, IL 60616-1386
(312) 794-5582
(312) 794-5579
Mailing address
221 E CULLERTON ST, UNIT 101A, CHICAGO, IL 60616-1386
(312) 794-5582
(312) 794-5579
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180.007708
IL
Other
Enumeration date
12/05/2011
Last updated
12/05/2011
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