Individual provider · Type 1 NPI
Charles Michael Ideran, D.MIN., LCPC
Mental Health Counselor · Oak Forest, IL
NPI number
1265446652
Active
Practice location
6006 W. 159th St, Bldg. C
Oak Forest, IL 60452
Mailing address
1404 Brassie Ave
Flossmoor, IL 60422-1814
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor | 101YP2500X | 180001087 (IL) |
| Mental Health Counselor Primary | 101YM0800X | LCPC 180-001087 (IL) |
Mental Health Counselor: Definition to come...
2 other providers at this address
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About NPI 1265446652
Charles Michael Ideran, D.MIN., LCPC's National Provider Identifier is 1265446652, issued on Jul 28, 2006. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Oak Forest, IL. The record was last updated on Dec 4, 2024.