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Organization

THE CHAMPION CENTER FOR BEHAVIORAL THERAPY INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LATRICE HARRELL (EXECUTIVE DIRECTOR)
(312) 536-7779
Entity
Organization

Contact information

Practice address
17500 SYCAMORE AVE, COUNTRY CLUB HILLS, IL 60478-4884
(312) 536-7779
Mailing address
17500 SYCAMORE AVE, COUNTRY CLUB HILLS, IL 60478-4884
(312) 536-7779

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
IL
103K00000X
Behavior Analyst
Primary
IL
103T00000X
Psychologist
IL
103TB0200X
Cognitive & Behavioral Psychologist
133N00000X
Nutritionist
133V00000X
Registered Dietitian
174400000X
Specialist
174H00000X
Health Educator
222Q00000X
Developmental Therapist
225CA2400X
Assistive Technology Practitioner Rehabilitation Counselor
225XF0002X
Feeding, Eating & Swallowing Occupational Therapist
225XR0403X
Driving and Community Mobility Occupational Therapist
231H00000X
Audiologist
235Z00000X
Speech-Language Pathologist

Other

Enumeration date
01/29/2016
Last updated
01/29/2016
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