Provider Demographics
NPI:1861244287
Name:CANELA PSYCHOTHERAPY CHICAGO
Entity type:Organization
Organization Name:CANELA PSYCHOTHERAPY CHICAGO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGICAL
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHALIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:HENAINE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, PSYD
Authorized Official - Phone:224-319-4076
Mailing Address - Street 1:3057 N ROCKWELL ST STE 261
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-7917
Mailing Address - Country:US
Mailing Address - Phone:224-319-4076
Mailing Address - Fax:
Practice Address - Street 1:3057 N ROCKWELL ST STE 261
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-7917
Practice Address - Country:US
Practice Address - Phone:224-319-4076
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-02
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty