Provider Demographics
NPI: | 1053184911 |
---|---|
Name: | EHP SEXOLOGICAL AND THERAPEUTIC SERVICES, PLLC |
Entity type: | Organization |
Organization Name: | EHP SEXOLOGICAL AND THERAPEUTIC SERVICES, PLLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO, MANAGER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | KAREN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | CAFFEE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | PHD, LMFT, MED, CST |
Authorized Official - Phone: | 312-971-6846 |
Mailing Address - Street 1: | 2735 HASSERT BLVD STE 135 |
Mailing Address - Street 2: | |
Mailing Address - City: | NAPERVILLE |
Mailing Address - State: | IL |
Mailing Address - Zip Code: | 60564-5205 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1567 TRAILS END LN |
Practice Address - Street 2: | |
Practice Address - City: | BOLINGBROOK |
Practice Address - State: | IL |
Practice Address - Zip Code: | 60490-3289 |
Practice Address - Country: | US |
Practice Address - Phone: | 312-971-6846 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2023-11-02 |
Last Update Date: | 2023-11-02 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 106H00000X | Behavioral Health & Social Service Providers | Marriage & Family Therapist | Group - Single Specialty |