| Doctor Name: | MS. SUSANA MONTENEGRO MCLELLAN |
| NPI Number: | 1073873535 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCPC, NCC, CADC |
| License Number: | 231141 |
| Business Practice Address: | 4753 N Broadway St Suite 720 Chicago, IL - 606405266 |
| Business Phone Number: | 7738993245 |
| Business Fax Number: | |
| Mailing Address: | 6516 N Greenview Ave, CHICAGO |
| State: | IL |
| Postal Code: | 606265008 |
| Phone Number: | 7738993245 |
| Fax Number: | |
| NPI Enumeration Date: | 05/18/2012 |
| NPI Last Update Date: | 05/18/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 231141 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| 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 |