Organization
ANITA MANDLEY LCPC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANITA A MANDLEY LCPC (OWNER)
(312) 509-2245
Entity
Organization
Contact information
Practice address
7514 KOSTNER AVE, SKOKIE, IL 60076-3828
(312) 509-2245
Mailing address
7514 KOSTNER AVE, SKOKIE, IL 60076-3828
(312) 509-2245
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180002457
CLINICAL COUNSELORPROFESSIONAL LICENSE
IL
Enumeration date
01/13/2022
Last updated
01/13/2022
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