Individual
CASEY WALTON TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
3046 W ARMITAGE AVE APT 1, CHICAGO, IL 60647-5935
(847) 849-9237
Mailing address
4345 N OAKLEY AVE UNIT 2, CHICAGO, IL 60618-1619
(847) 849-9237
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
178.013798
IL
101YM0800X
Mental Health Counselor
Primary
180012644
IL
Other
Enumeration date
06/14/2018
Last updated
08/16/2021
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