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Individual

ELISSA MCNICHOLAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4050 N LINCOLN AVE, CHICAGO, IL 60618-3067
(312) 401-6574
Mailing address
2834 W BERWYN AVE APT 1E, CHICAGO, IL 60625-3433

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary

Other

Enumeration date
01/30/2020
Last updated
01/30/2020
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