Organization
SELF CONNECTED THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY GROB LCSW (THERAPIST)
(847) 942-7849
Entity
Organization
Contact information
Practice address
2189 N. RT. 83, #292, ROUND LAKE BEACH, IL 60073
(847) 942-7849
Mailing address
2189 N. RT. 83, #292, ROUND LAKE BEACH, IL 60073
(847) 942-7849
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
09/03/2020
Last updated
09/03/2020
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