Provider Demographics
NPI:1053812149
Name:SHE IS STRONG AND MINDFUL
Entity type:Organization
Organization Name:SHE IS STRONG AND MINDFUL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPSIT
Authorized Official - Prefix:
Authorized Official - First Name:LORENA
Authorized Official - Middle Name:S
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MSW, LCSW
Authorized Official - Phone:312-279-8870
Mailing Address - Street 1:2711 N KENMORE AVE APT F1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-1376
Mailing Address - Country:US
Mailing Address - Phone:217-274-8901
Mailing Address - Fax:
Practice Address - Street 1:1300 W BELMONT AVE STE 209
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-3284
Practice Address - Country:US
Practice Address - Phone:312-279-8870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490194121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty