Allyssa Rose Bertram, LCPC CADC
Counselor in Chicago, IL. Individual provider (NPI-1).
NPI number1366058075
StatusActive
Last updated in NPPESSep 17, 2020
Details
- NPI
- 1366058075
- Entity type
- Individual (NPI-1)
- Name
- Allyssa Rose Bertram
- Credential
- LCPC CADC
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 17, 2020
- Certification date
- Sep 17, 2020
- Last updated
- Sep 17, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | 180.012157 | IL | Yes |
Practice location
4055 W Peterson Ave Ste 202Chicago, IL 60646-6183
Phone 773-774-4444
Mailing address
702 Dempster St Apt E105Mount Prospect, IL 60056-6154
Phone 440-452-5245
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