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Organization
PARK RIDGE PSYCHOTHERAPY AND COUNSELING SERVICES, INC.
Active
Organization
PARK RIDGE PSYCHOTHERAPY AND COUNSELING SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA MARIE COSTANZA M.A., LCPC (PRESIDENT/LCPC/PSYCHOTHERAPIST)
(312) 788-7874
Entity
Organization
Contact information
Practice address
350 S NORTHWEST HWY STE 300, PARK RIDGE, IL 60068-4262
(312) 788-7874
Mailing address
350 S NORTHWEST HWY STE 300, PARK RIDGE, IL 60068-4262
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180010333
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1568710432
INDIVIDUAL
IL
Enumeration date
09/06/2017
Last updated
09/25/2017
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