DYAMOND BRUCE
NPI 1255004156
Counselor - Mental Health in Chicago, IL
Active since July 27, 2021
About Dyamond Bruce NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DYAMOND BRUCE (NPI 1255004156) is an individual mental health provider in Chicago, Illinois and active in the NPI registry since July 2021.
NPPES Registry Identity
NPI1255004156
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameDYAMOND BRUCE
Location Address721 N LASALLE DRChicago, IL 60654
Mailing Address611 Larkspur LnMatteson, IL 60443-1771 · (773) 354-2346
Phone(312) 655-7167
Sole ProprietorYes
Enumeration DateJuly 27, 2021
NPPES CertifiedJune 29, 2021
✔ NPI 1255004156 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
721 N LASALLE DR, Chicago, IL 60654
Group Practice 1
Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1255004156, enumerated as an "individual" on July 27, 2021.
The provider is located at 721 N LASALLE DR CHICAGO, IL 60654 and the phone number is (312) 655-7167.
Counselor with taxonomy code 101YM0800X and a focus in Mental Health.
