Provider Demographics
NPI:1386391282
Name:HALCYON COUNSELING AND PSYCHOTHERAPY SERVICES LLC
Entity type:Organization
Organization Name:HALCYON COUNSELING AND PSYCHOTHERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:FORJETTE
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:773-828-0300
Mailing Address - Street 1:1343 W DEVON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-1329
Mailing Address - Country:US
Mailing Address - Phone:773-828-0300
Mailing Address - Fax:
Practice Address - Street 1:1343 W DEVON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60660-1329
Practice Address - Country:US
Practice Address - Phone:773-828-0300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-10
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty