Organization
FOUNDATIONS COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA LOUISE ALLEN MSW, LCSW (CEO/ MENTAL HEALTH THERAPIST)
(708) 529-0122
Entity
Organization
Contact information
Practice address
9730 S WESTERN AVE STE 215, EVERGREEN PARK, IL 60805
(773) 242-9726
Mailing address
9730 S WESTERN AVE STE 215, EVERGREEN PARK, IL 60805-2871
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149019762
IL
Other
Enumeration date
10/26/2017
Last updated
07/20/2018
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