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Organization

BLACK DOG PSYCHOTHERAPY PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MEREDITH EVETT LCSW (OWNER)
(512) 815-3186
Entity
Organization

Contact information

Practice address
1525 W CARMEN AVE APT 2, CHICAGO, IL 60640-8574
(512) 815-3186
Mailing address
1525 W CARMEN AVE APT 2, CHICAGO, IL 60640-8574

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Enumeration date
07/15/2025
Last updated
07/15/2025
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