Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
N | 101YM0800X | Mental Health Counselor | ||
Y | 101YP2500X | Professional Counselor | ||
N | 103TC2200X | Clinical Child & Adolescent Psychologist | ||
N | 103TF0200X | Forensic Psychologist | ||
N | 103TP2701X | Group Psychotherapist | ||
N | 103TR0400X | Rehabilitation Psychologist | ||
N | 1041C0700X | Clinical Social Worker |
NPI | 1194490144 |
---|---|
Provider Name | Rachael Krajewski |
First Address | Chicago, IL 60601-7713 |
Second Address | Chicago, IL 60601-7710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2021 |
Last Update Date | 11/08/2021 |