Life Synergy, LLC
Counselor, Professional in Homer Glen, IL. Organization (NPI-2).
NPI number1114332004
StatusActive
Last updated in NPPESJun 30, 2014
Details
- NPI
- 1114332004
- Entity type
- Organization (NPI-2)
- Legal business name
- Life Synergy, LLC
- Organization subpart
- No
- Enumeration date
- Jun 30, 2014
- Last updated
- Jun 30, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 180008797 | IL | Yes |
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | 30730 | IL |
Practice location
13235 W Hiawatha DrHomer Glen, IL 60491-8637
Phone 708-927-2449
Mailing address
13235 W Hiawatha DrHomer Glen, IL 60491-8637
Authorized official
Karen L Vachulcik
Licensed Clinical Prof Counselor
7089272449
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