Organization
COACHING AND THERAPEUTIC INTERACTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHOEBE VAN HAM MSW (THERAPIST)
(630) 260-1166
Entity
Organization
Contact information
Practice address
705 WARRENVILLE RD, WHEATON, IL 60187-6379
(630) 260-1166
(630) 344-1315
Mailing address
705 WARRENVILLE RD, WHEATON, IL 60187-6379
(630) 260-1166
(630) 344-1315
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149001872
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2233100
BCBS
IL
Enumeration date
04/12/2007
Last updated
06/13/2008
Update your record
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