Organization
BROOKE PETERSEN COUNSELING PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BROOKE N PETERSEN LCPC (PSYCHOTHERAPIST)
(630) 803-1062
Entity
Organization
Contact information
Practice address
3609 N MAGNOLIA AVE, CHICAGO, IL 60613-3820
(630) 803-1062
Mailing address
547 S CLARK ST APT 1001, CHICAGO, IL 60605-1547
(630) 803-1062
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180013512
LCPC
IL
Enumeration date
05/11/2021
Last updated
05/11/2021
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