Organization
AUTHENTICALLY LIVING PSYCHOLOGICAL SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA SHAW PSYD (OWNER)
(312) 600-3775
Entity
Organization
Contact information
Practice address
159 N SANGAMON ST STE 200&300, CHICAGO, IL 60607-2201
(312) 600-3775
Mailing address
159 N SANGAMON ST STE 200&300, CHICAGO, IL 60607-2201
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
08/02/2023
Last updated
08/02/2023
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