Jenaye Beavers

Individual provider Active NPI Marriage & Family Therapist · Chicago, IL

NPI 1124853064 · NPPES record last updated Sep 2, 2024

Key facts

NPI
1124853064
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
Practice address
1770 W Berteau Ave Ste 304
Chicago, IL 60613-6131
Phone
(312) 210-0576
NPI assigned
Sep 2, 2024
Sex
Female
Sole proprietor
Yes

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
Marriage & Family Therapist 106H00000X Yes

Addresses

Primary practice location

1770 W Berteau Ave Ste 304
Chicago, IL 60613-6131

Mailing address

1770 W Berteau Ave Ste 304
Chicago, IL 60613-6131

Other providers in Chicago, IL

All providers in Chicago, IL · Marriage & Family Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.