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Organization

CREATIVE ROOTS COUNSELING, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KRISTINA VOGT LCPC, ATR (PSYCHOTHERAPIST)
(773) 466-4527
Entity
Organization

Contact information

Practice address
4305 N LINCOLN AVE STE K, CHICAGO, IL 60618-1807
(773) 466-4527
Mailing address
4305 N LINCOLN AVE STE K, CHICAGO, IL 60618-1807
(773) 466-4527

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180008745
IL

Other

Enumeration date
07/18/2017
Last updated
07/21/2022
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