Provider Demographics
NPI:1487152229
Name:AD ASTRA, AYDA (LMFT)
Entity type:Individual
Prefix:
First Name:AYDA
Middle Name:
Last Name:AD ASTRA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:ADAORA
Other - Middle Name:
Other - Last Name:AGUOJI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:3546 N BOSWORTH AVE
Mailing Address - Street 2:APT. 3
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3546 N BOSWORTH AVE
Practice Address - Street 2:APT. 3
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-3241
Practice Address - Country:US
Practice Address - Phone:847-859-9862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-26
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208.000637106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist