Organization
MINDFUL THERAPY SOLUTIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CANDACE KULCZYCKI LCSW (LICENSED CLINICAL SOCIAL WORKER)
(847) 274-1757
Entity
Organization
Contact information
Practice address
2724 W LOGAN BLVD APT GDN, CHICAGO, IL 60647-9729
(847) 274-1757
Mailing address
2724 W LOGAN BLVD APT GDN, CHICAGO, IL 60647-9729
(847) 274-1757
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
348867811001
—
IL
Enumeration date
04/22/2020
Last updated
04/22/2020
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