OrganizationActive
Black Excellence Psychotherapy PLLC
NPI 1700539681 · Adolescent and Children Mental Health Clinic/Center · Lake Bluff, IL
Provider details
- NPI number
- 1700539681
- Entity type
- Organization
- Primary specialty
- Adolescent and Children Mental Health Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Fitzgerald Ajoku, Founder(914) 609-1183
Specialties & taxonomies
Ambulatory Health Care Facilities
- Adult Mental Health Clinic/Center261QM0850X
Ambulatory Health Care Facilities
Practice location
30047 N Waukegan Rd
Lake Bluff, IL 60044-1023
Phone: (718) 342-4986
Approximate (ZIP-level) locationGet directions
Mailing address
30047 N Waukegan Rd
Lake Bluff, IL 60044-1023
Registry dates
- Enumerated
- 2022-01-31
- Last updated
- 2022-10-16
- Certified
- 2022-10-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.