Organization
CRYSTAL LAKE WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DESPINA MCBRIDE-SPENCER LCPC (OWNER)
(815) 893-9839
Entity
Organization
Contact information
Practice address
610 CRYSTAL POINT DR STE 2, CRYSTAL LAKE, IL 60014-1400
(815) 893-9839
Mailing address
610 CRYSTAL POINT DR STE 2, CRYSTAL LAKE, IL 60014-1400
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/22/2015
Last updated
04/22/2015
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