Individual
JACLYN S STORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
814 W SUNNYSIDE AVE APT GB, CHICAGO, IL 60640-6131
(773) 369-0608
Mailing address
30 N MICHIGAN AVE STE 1126, CHICAGO, IL 60602-3737
(773) 369-0608
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
149.023798
IL
Other
Enumeration date
11/17/2022
Last updated
12/19/2022
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