Individual
BEVERLY BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC, CADC
Contact information
Practice address
1026 W LAWRENCE AVE, CHICAGO, IL 60640-5018
(773) 989-9400
Mailing address
1026 W LAWRENCE AVE, CHICAGO, IL 60640-5018
(773) 989-9400
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180.001729
IL
Other
Enumeration date
06/06/2024
Last updated
06/06/2024
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