Organization
BLACKMON COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIE L BLACKMON LCPC MA (LICENSED PROFESSIONAL COUNSELOR)
(773) 934-5668
Entity
Organization
Contact information
Practice address
5834 S MAPLEWOOD AVE, CHICAGO, IL 60629-1124
(773) 778-4835
Mailing address
5834 S MAPLEWOOD AVE, CHICAGO, IL 60629-1124
(773) 778-4835
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
180.007189
IL
Other
Enumeration date
08/20/2013
Last updated
08/20/2013
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