Organization
OLD OAK PSYCHOLOGICAL HEALTH CENTER, LLC
Active
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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