Individual
ABENA NTIM-ADDAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, NCC, LPC
Contact information
Practice address
1700 W IRVING PARK RD STE 104, CHICAGO, IL 60613-2596
(872) 228-6416
Mailing address
1746 W NORTH SHORE AVE APT 2, CHICAGO, IL 60626-6575
(331) 269-5619
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
178.019968
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16145266
COUNCIL FOR AFFORDABLE QUALITY HEALTHCARE (CAQH)
—
Enumeration date
10/02/2023
Last updated
03/08/2024
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