Organization
GOL RELATIONAL CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. FATEME TARGOL HASANKHANI (LMFT)
(773) 366-4901
Entity
Organization
Contact information
Practice address
4611 N RAVENSWOOD AVE STE 205, CHICAGO, IL 60640-7577
(773) 366-4901
Mailing address
4611 N RAVENSWOOD AVE STE 205, CHICAGO, IL 60640-7577
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
11/22/2019
Last updated
12/10/2023
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