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NPI Code Detail

MEDICARE: INNOVATIVE COUNSELING PARTNERS LLC

MEDICARE: INNOVATIVE COUNSELING PARTNERS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0855XAdolescent and Children Mental Health Clinic/Center248001003IL
2261QM0850XAdult Mental Health Clinic/Center248001003IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437563798
Entity Type Code : Organization
Provider Name (Legal Business Name) : INNOVATIVE COUNSELING PARTNERS LLC
Provider Business Mailing Address
First Line : 715 LAKE ST STE 800
Second Line :
City : OAK PARK
State : IL
Zip : 60301-1417
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 715 LAKE ST STE 806
Second Line :
City : OAK PARK
State : IL
Zip : 60301-1417
Country : US
Telephone Number : 312-343-7400
Fax Number :
Authorized Official
Title or Position : CEO/OWNER
Name : JENNIFER FROEMEL
Credential : LCPC
Telephone Number : 312-343-7400
Provider Enumeration Date : 06/16/2014
Last Update Date : 01/03/2022

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Directions to “INNOVATIVE COUNSELING PARTNERS LLC ” Practice Location

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