Organization
OLD OAK PSYCHOLOGICAL HEALTH CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMY LUCE MA, PSYD (LICENSED CLINICAL PSYCHOLOGIST)
(847) 999-3888
Entity
Organization
Contact information
Practice address
401 E PROSPECT AVE STE 218, MT PROSPECT, IL 60056-3396
(847) 999-3888
Mailing address
401 E PROSPECT AVE STE 218, MT PROSPECT, IL 60056-3396
(847) 999-3888
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
07/09/2019
Last updated
10/08/2019
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