Organization
VELVET & VINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN J SAUER (PRACTICE MANAGEMENT COORDINATOR)
(414) 607-2553
Entity
Organization
Contact information
Practice address
1357 W ARGYLE ST APT 3C, CHICAGO, IL 60640-8412
(817) 896-2707
Mailing address
112 E BURLINGTON AVE STE 519, LA GRANGE, IL 60525-2481
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
103G00000X
Clinical Neuropsychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC1900X
Counseling Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
05/12/2025
Last updated
05/12/2025
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