institution
Modern Soul Therapy Llc
Mental Health Counselor in Chicago, Illinois
NPI 1013516145

Modern Soul Therapy Llc is a Mental Health Counselor based in Brighton, IL and is specialized in Mental Health. Modern Soul Therapy Llc practices in Chicago, IL. The NPI Number for Modern Soul Therapy Llc is 1013516145 and holds a License No. (Illinois).

The current practice location address for Modern Soul Therapy Llc is 2000 N Racine Ave Ste 2160, Chicago, IL and can be reached out via phone at 740-408-6407.

Location: 2000 N Racine Ave Ste 2160, Chicago, IL, 02135-2754
institution
Provider Profile Details
NPI Number
1013516145
Provider Name
Modern Soul Therapy Llc
Credential
Provider Entity Type
Organization
Address
2000 N Racine Ave Ste 2160, Chicago, IL, 02135-2754
Phone Number
740-408-6407
Fax Number
Provider Enumeration Date
10/20/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
09322531 01 PRIVATE INSURANCE
institution
Provider Business Practice Location Address Details
Address
2000 N Racine Ave Ste 2160
City
State
Zip
60614-4045
Phone Number
740-408-6407
Fax Number
person
Provider Business Mailing Address Details
Address
2000 N Racine Ave Ste 2160
City
State
Zip
60614-4045
Phone Number
740-408-6407
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
()
Definition
Definition to come...
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