Organization
ACTIVE THERAPIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEX SMITH (CREDENTIALING DIRECTOR)
(240) 329-4959
Entity
Organization
Contact information
Practice address
5746 N VIRGINIA AVE, CHICAGO, IL 60659-3719
(773) 562-3558
Mailing address
5746 N VIRGINIA AVE, CHICAGO, IL 60659-3719
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/19/2022
Last updated
02/04/2025
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