Organization Name: | DANIEL FERENCE LCPC, INC |
NPI Number: | 1033545769 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DANIEL FERENCE (OWNER/LCPC) |
Mailing Address: | 72 S La Grange Rd Suite 6 La Grange |
State: | IL US |
Postal Code: | 605252475 |
Phone Number: | 7084979729 |
Fax Number: | |
NPI Enumeration Date: | 09/26/2013 |
NPI Last Update Date: | 09/26/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 180.008749 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |