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Organization
SELF ASSEMBLED PSYCHOTHERAPY, PLLC
Active
Organization
SELF ASSEMBLED PSYCHOTHERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE JELLINEK ALDAG LCPC, NCC (FOUNDER & BILINGUAL PSYCHOTHERAPIST)
(608) 217-4711
Entity
Organization
Contact information
Practice address
5206 N LIND AVE, CHICAGO, IL 60630-1436
(608) 217-4711
Mailing address
5206 N LIND AVE, CHICAGO, IL 60630-1436
(608) 217-4711
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1760098966
LICENSED PROFESSIONAL COUNSELOR
IL
Enumeration date
09/26/2022
Last updated
10/24/2022
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