Holly Ambruso

Individual provider Active NPI Mental Health Counselor · Melrose Park, IL

NPI 1043881832 · NPPES record last updated Jul 2, 2021

Key facts

NPI
1043881832
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
1414 Main St
Melrose Park, IL 60160-3902
Phone
(708) 681-0073
NPI assigned
Jul 2, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

1414 Main St
Melrose Park, IL 60160-3902

Mailing address

1820 S 25TH Ave
Broadview, IL 60155-3960
Phone (708) 681-0073

Other providers in Melrose Park, IL

All providers in Melrose Park, IL · Mental Health Counselor in Illinois

Sources for this page

Verify at the official NPI Registry.