Cardwell, Shenandoah

Cardwell, Shenandoah is an sole proprietor health care provider with primary practice located at 34930 N Us Highway 45 Suite 101, Lake Villa IL 60046-7537. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Counselor is her primary health care specialty. Cardwell, Shenandoah can be contacted via phone (847) 543-7755.

Contact Information

Primary practice address
34930 N Us Highway 45 Suite 101 Lake Villa IL 60046-7537
Phone: (847) 543-7755
Fax: (847) 543-7759
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X NCC CERT # 22818
Behavioral Health & Social Service Providers / Professional 101YP2500X 2906-125 Wisconsin
Behavioral Health & Social Service Providers / Professional 101YP2500X Illinois

Profile Details

NPI number 1710098611
LBN Legal business name Cardwell, Shenandoah
Credentials MA, NCC, LCPC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 31st, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710098611 NPPES
Illinois Other 169887 MHN PROVIDER #

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