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Organization
WAKEFUL PSYCHOLOGICAL AND CONSULTING SERVICES, PLLC
Active
Organization
WAKEFUL PSYCHOLOGICAL AND CONSULTING SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAK-SENG LODRO PSY.D. (OWNER/EXECUTIVE DIRECTOR)
(312) 810-6681
Entity
Organization
Contact information
Practice address
1740 RIDGE AVE STE 200C, EVANSTON, IL 60201-5918
(312) 690-3719
(224) 999-6781
Mailing address
1740 RIDGE AVE STE 200C, EVANSTON, IL 60201-5918
(312) 690-3719
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TF0000X
Family Psychologist
—
—
Other
Enumeration date
01/07/2019
Last updated
07/10/2024
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