Organization
SAMANTHA DALLAS LCPC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA JANE DALLAS LCPC (OWNER)
(815) 474-3380
Entity
Organization
Contact information
Practice address
20 N CLARK ST STE 1103, CHICAGO, IL 60602-4190
(815) 474-3380
Mailing address
218 N JEFFERSON ST STE 200, CHICAGO, IL 60661-1115
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/06/2024
Last updated
11/08/2024
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