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Organization
INKWELL PSYCHOTHERAPY
Active
Organization
INKWELL PSYCHOTHERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE M FOWLER LCPC, CADC (OWNER, THERAPIST)
(773) 669-4975
Entity
Organization
Contact information
Practice address
4305 N LINCOLN AVE STE L, CHICAGO, IL 60618-1807
(773) 669-4975
(844) 669-3667
Mailing address
4305 N LINCOLN AVE STE L, CHICAGO, IL 60618-1807
(773) 669-4975
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
02/07/2020
Last updated
02/07/2020
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