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Organization

CHICAGO CENTER FOR CONSCIOUS LIVING

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MEREDITH COHN SRIVASTAVA LCSW (PSYCHOTHERAPIST)
(773) 480-5297
Entity
Organization

Contact information

Practice address
5100 N RAVENSWOOD AVE, SUITE 211, CHICAGO, IL 60640-1710
(773) 480-5297
Mailing address
5100 N RAVENSWOOD AVE, SUITE 211, CHICAGO, IL 60640-1710
(773) 480-5297

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149011049
IL

Other

Enumeration date
05/16/2016
Last updated
05/16/2016
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