# CHICAGO LAKESHORE PSYCHOTHERAPY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336795863
- **Authorized official:** MARY K HOTZE LMFT (OWNER)
- **Authorized official phone:** (773) 351-9239

## Contact information

- **Practice address:** 155 N MICHIGAN AVE STE 714, CHICAGO, IL 60601-7706
- **Practice address phone:** (773) 474-2795
- **Mailing address:** 2014 W FLETCHER ST APT 1, CHICAGO, IL 60618-6418
- **Mailing address phone:** (773) 351-9239

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 08/12/2019
- **Last updated:** 08/12/2019