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Organization
SPARK CHICAGO THERAPY LLC
Active
Organization
SPARK CHICAGO THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY MORAN LCPC (OWNER)
(630) 319-1244
Entity
Organization
Contact information
Practice address
945 W GEORGE ST STE 201, CHICAGO, IL 60657-7185
(630) 319-1244
Mailing address
945 W GEORGE ST STE 201, CHICAGO, IL 60657-7185
(630) 319-1244
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
10/12/2018
Last updated
07/15/2024
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