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Individual

ALLYSSA ROSE BERTRAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCPC CADC

Contact information

Practice address
4055 W PETERSON AVE STE 202, CHICAGO, IL 60646-6183
(773) 774-4444
Mailing address
702 DEMPSTER ST APT E105, MOUNT PROSPECT, IL 60056-6154
(440) 452-5245

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
180.012157
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
180.012157
LCPC
IL
Enumeration date
09/17/2020
Last updated
09/17/2020
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