Provider Demographics
NPI:1871305896
Name:EBB & FLOW PSYCHOTHERAPY PLLC
Entity type:Organization
Organization Name:EBB & FLOW PSYCHOTHERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOESTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-633-8868
Mailing Address - Street 1:5406 W BERENICE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-2511
Mailing Address - Country:US
Mailing Address - Phone:773-633-8868
Mailing Address - Fax:
Practice Address - Street 1:1000 N MILWAUKEE AVE STE 305
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60642-4000
Practice Address - Country:US
Practice Address - Phone:773-633-8868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-25
Last Update Date:2025-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty