Organization
ELYSIAN MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASSIDY R BUCKELEW (PSYCHOLOGIST, OWNER)
(708) 292-8373
Entity
Organization
Contact information
Practice address
708 CHURCH ST STE 223, EVANSTON, IL 60201-3881
(989) 326-5621
Mailing address
708 CHURCH ST STE 223, EVANSTON, IL 60201-3881
(989) 326-5621
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
09/21/2024
Last updated
11/18/2024
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