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Organization

VISIONS FOR CHANGE COUNSELING CENTER, PC

Active
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Organization

VISIONS FOR CHANGE COUNSELING CENTER, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RICHARA C. JENNINGS PSYD, LCPC (ADMINISTRATIVE DIRECTOR)
(773) 238-1992
Entity
Organization

Contact information

Practice address
9510 S CONSTANCE AVE, SUITE C6, CHICAGO, IL 60617-4700
(773) 510-0104
(773) 731-9711
Mailing address
9510 S CONSTANCE AVE, SUITE C6, CHICAGO, IL 60617-4700
(773) 510-0104
(773) 731-9711

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071007563
IL

Other

Enumeration date
05/18/2007
Last updated
03/13/2009
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