Individual
ELIZABETH BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LCPC
Contact information
Practice address
5 REVERE DR, SUITE 100, NORTHBROOK, IL 60062-1566
(847) 291-6805
Mailing address
5 REVERE DR, SUITE 100, NORTHBROOK, IL 60062-1566
(847) 291-6805
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
178.009341
IL
101YM0800X
Mental Health Counselor
Primary
180010188
IL
Other
Enumeration date
06/30/2014
Last updated
08/05/2016
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