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Organization

AMANDA BROOKE EASTON, CLINICAL PROFESSIONAL COUNSELING, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AMANDA EASTON MS, CRC, LCPC (PRACTICE OWNER AND MANAGER)
(312) 622-8617
Entity
Organization

Contact information

Practice address
3105 S DEARBORN ST, PSYCHOLOGY DEPARTMENT, CHICAGO, IL 60616-2852
(312) 622-8617
Mailing address
1727 S INDIANA AVE, UNIT 324, CHICAGO, IL 60616-1390
(312) 622-8617

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180008978
IL

Other

Enumeration date
10/07/2014
Last updated
10/07/2014
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