Crawford Avenue Group INC
Psychologist, Clinical in Evanston, IL. Organization (NPI-2).
NPI number1013409366
StatusActive
Last updated in NPPESJun 2, 2018
Details
- NPI
- 1013409366
- Entity type
- Organization (NPI-2)
- Legal business name
- Crawford Avenue Group INC
- Organization subpart
- No
- Enumeration date
- Jun 2, 2018
- Last updated
- Jun 2, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 071007124 | IL | Yes |
| 1041C0700X | Social Worker, Clinical | 149003065 | IL |
Practice location
2530 Crawford Ave Ste 206Evanston, IL 60201-4959
Phone 847-875-4411
Mailing address
2530 Crawford Ave Ste 206Evanston, IL 60201-4959
Other practice locations
2530 Crawford Ave Ste 212
Evanston, IL 60201-4959
Evanston, IL 60201-4959
Phone 847-604-1945 · Fax 847-733-1217
Authorized official
Kelli Klinger
President
8478754411
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