Organization
BALANCED MIND PSYCHOTHERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE DUNLAP LCPC (OWNER/PRACTICE MANGER AND THERAPIST)
(309) 236-0501
Entity
Organization
Contact information
Practice address
180 N MICHIGAN AVE STE 1510, CHICAGO, IL 60601-7484
(708) 831-3782
Mailing address
2321 11TH ST, MOLINE, IL 61265-4756
(708) 831-3782
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14410974
COUNCIL FOR AFFORDABLE QUALITY HEALTHCARE
IL
Enumeration date
12/23/2022
Last updated
12/23/2022
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