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Organization
MOSAIC LEAF THERAPY AND WELLNESS, LLC
Active
Organization
MOSAIC LEAF THERAPY AND WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THERESSA L LABARRIE MITCHELL PHD (CLINICAL PSYCHOLOGIST AND FOUNDER)
(312) 522-8280
Entity
Organization
Contact information
Practice address
200 W MADISON ST STE 2100, CHICAGO, IL 60606
(312) 522-8280
Mailing address
200 W MADISON ST STE 2100, CHICAGO, IL 60606-3521
(312) 522-8280
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
071.009800
IL
261QM0850X
Adult Mental Health Clinic/Center
071.009800
IL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
071.009800
IL
Other
Enumeration date
08/09/2018
Last updated
09/06/2018
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