Organization
CHICAGO GROWTH MINDSET LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NILSA RUIZ LCSW (CO-OWNER)
(773) 641-1321
Entity
Organization
Contact information
Practice address
3111 N CICERO AVE, CHICAGO, IL 60641-5110
(773) 641-1321
Mailing address
3111 N CICERO AVE, CHICAGO, IL 60641-5110
(773) 641-1321
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
104100000X
Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
02/18/2019
Last updated
02/18/2019
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