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Contact Information

RADICAL AUTHENTICITY & WELLNESS PSYCHOTHERAPY GROUP LLC
1554 W HOLLYWOOD AVE
CHICAGO, IL60660-4399
 Phone: 434-284-3806
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
 

Clinical

103TC0700X 62 Psychologist, Clinical
 

Counseling

103TC1900X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for RADICAL AUTHENTICITY WELLNESS PSYCHOTHERAPY GROUP LLC · (Female)

NPI Number 1538875687
Status Active
Credentials
Entity Individual
Enumeration date 01/23/2023
Last updated 01/23/2023 - About 3 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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