person
Ian Broderick Gough, MS,LPC
Professional Counselor in Chicago, Illinois
NPI 1568134625

Ian Broderick Gough is a Professional Counselor based in Chicago, IL and is specialized in Professional. Ian Broderick Gough practices in Chicago, IL and has the professional credentials of MS,LPC. The NPI Number for Ian Broderick Gough is 1568134625 and holds a License No. (Illinois).

The current practice location address for Ian Broderick Gough is 1616 N Damen Ave Unit 301, Chicago, IL and can be reached out via phone at 888-303-2844.

Location: 1616 N Damen Ave Unit 301, Chicago, IL, 60647-5536
person
Provider Profile Details
NPI Number
1568134625
Provider Name
Ian Broderick Gough
Credential
MS,LPC
Provider Entity Type
Individual
Gender
Male
Address
1616 N Damen Ave Unit 301, Chicago, IL, 60647-5536
Phone Number
888-303-2844
Fax Number
Provider Enumeration Date
09/28/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1616 N Damen Ave Unit 301
City
State
Zip
60647-5536
Phone Number
888-303-2844
Fax Number
person
Provider Business Mailing Address Details
Address
1616 N Damen Ave Unit 301
City
State
Zip
60647-5536
Phone Number
888-303-2844
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
License No.
178018226 (Illinois)
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's degree and clinical experience and supervision for licensure or certification.
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
()
Definition
Definition to come...
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