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Organization

AMETHYST THERAPY P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LAKESHIA M SUMRALL-CARR LCPC (OWNER)
(773) 793-3386
Entity
Organization

Contact information

Practice address
1809 W 95TH ST, CHICAGO, IL 60643-1103
(708) 568-1770
Mailing address
9128 S TROY AVE, EVERGREEN PARK, IL 60805-1628

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
180007546
IL

Other

Enumeration date
10/24/2015
Last updated
10/24/2015
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