Individual
CLARA ELISA BRENNECKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A. LCPC
Contact information
Practice address
1122 W HUBBARD ST, UNIT 3E, CHICAGO, IL 60642-8805
(312) 405-2784
Mailing address
1122 W HUBBARD ST, UNIT 3E, CHICAGO, IL 60642-8805
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
180.010376
IL
Other
Enumeration date
08/18/2016
Last updated
03/16/2018
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