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Organization
YOUR THERAPY S.P.A.C.E. LLC
Active
Organization
YOUR THERAPY S.P.A.C.E. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IMANI ALIMA IBRAHIM LCSW (OWNER)
(630) 429-4356
Entity
Organization
Contact information
Practice address
5113 S HARPER AVE # 2079, CHICAGO, IL 60615-4119
(708) 803-2988
Mailing address
5113 S HARPER AVE # 2079, CHICAGO, IL 60615-4119
(708) 803-2988
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
02/28/2023
Last updated
02/28/2023
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