Individual
GWEN N CLANCY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
1448 N MILWAUKEE AVE STE 201, CHICAGO, IL 60622-9225
(312) 476-9064
(630) 839-8697
Mailing address
1448 N MILWAUKEE AVE STE 201, CHICAGO, IL 60622-9225
(312) 476-9064
(630) 839-8697
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
180.012251
IL
Other
Enumeration date
07/07/2019
Last updated
07/07/2019
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