Organization
CENTER FOR PERSONAL GROWTH, PLLC
Active
Other names
Center for Personal Growth
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIERA E LIEBICH (OFFICE MANAGER)
(630) 791-0118
Entity
Organization
Contact information
Practice address
640 E SAINT CHARLES RD STE 212, CAROL STREAM, IL 60188-2600
(630) 791-0118
(630) 708-7654
Mailing address
640 E SAINT CHARLES RD STE 212, CAROL STREAM, IL 60188-2600
(630) 791-0118
(630) 708-7654
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071.008385
IL
103TC2200X
Clinical Child & Adolescent Psychologist
071.008385
IL
103TH0100X
Health Service Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
321707109001
—
IL
Enumeration date
10/25/2014
Last updated
02/24/2024
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