Individual provider · Type 1 NPI

Charlisa Sukrasebya Mao

Mental Health Counselor · Elgin, IL

NPI number 1649029448 Active

Practice location

1845 Grandstand Pl
Elgin, IL 60123-6603

Mailing address

220 Gertrude St
Elgin, IL 60123-6214

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1649029448

Charlisa Sukrasebya Mao's National Provider Identifier is 1649029448, issued on May 14, 2024. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Elgin, IL. The record was last updated on May 14, 2024.