Individual provider · Type 1 NPI

Madeline Olivia Sansom

Mental Health Counselor · Chicago, IL

NPI number 1689413148 Active

Practice location

1147 W Ohio St Ste 103
Chicago, IL 60642-5874

Mailing address

1147 W Ohio St Unit 103
Chicago, IL 60642

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800XNone listed
Mental Health Counselor Primary 101YM0800XPRE-LIC

Mental Health Counselor: Definition to come...

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About NPI 1689413148

Madeline Olivia Sansom's National Provider Identifier is 1689413148, issued on May 23, 2024. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Chicago, IL. The record was last updated on May 23, 2024.