Organization Name: | ETERNITYS PATH LLC A COUNSELING AND FAMILY RESOURCE CENTER |
NPI Number: | 1033519707 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JSHAUNTAE MARSHALL (OWNER) |
Mailing Address: | 444 N Michigan Ave Ste 1200 Chicago |
State: | IL US |
Postal Code: | 606113959 |
Phone Number: | 3122765155 |
Fax Number: | 7029103231 |
NPI Enumeration Date: | 08/29/2014 |
NPI Last Update Date: | 08/29/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |