Individual
MR. JOSHUA SMITH HETHERINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSMFT
Contact information
Practice address
1770 W BERTEAU AVE, CHICAGO, IL 60613-1849
(773) 791-0469
Mailing address
1138 W NORTH SHORE AVE, APT 1S, CHICAGO, IL 60626-4664
(773) 791-0469
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
180-003937
IL
106H00000X
Marriage & Family Therapist
Primary
166-000557
IL
Other
Enumeration date
02/26/2007
Last updated
04/26/2011
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