George, Juvenal

George, Juvenal is an sole proprietor health care provider with primary practice located at 701 Devonshire Dr Suite 203C Bldg C, Champaign IL 61820. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. George, Juvenal can be contacted via phone (708) 381-0445.

Contact Information

Primary practice address
701 Devonshire Dr Suite 203C Bldg C Champaign IL 61820
Phone: (708) 381-0445
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 071010536 Illinois
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1821422932
LBN Legal business name George, Juvenal
Credentials PSY.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 26th, 2013
Last updated Aug 4th, 2022 - about 4 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.

Request for update

Popular Providers