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NPI Code Detail

MEDICARE: TELOS COUNSELING SERVICES PLLC

MEDICARE: TELOS COUNSELING SERVICES PLLC
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1861376238
Entity Type Code : Organization
Provider Name (Legal Business Name) : TELOS COUNSELING SERVICES PLLC
Provider Business Mailing Address
First Line : 11020 BAYOU CT
Second Line :
City : HUNTLEY
State : IL
Zip : 60142-8186
Country : US
Telephone Number : 281-475-6906
Fax Number :
Provider Business Practice Location Address
First Line : 970 S MCHENRY AVE
Second Line :
City : CRYSTAL LAKE
State : IL
Zip : 60014-7449
Country : US
Telephone Number : 281-475-6906
Fax Number :
Authorized Official
Title or Position : OWNER
Name : JEREMY PHELPS
Credential : LCPC
Telephone Number : 281-475-6906
Provider Enumeration Date : 07/31/2025
Last Update Date : 07/31/2025

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Directions to “TELOS COUNSELING SERVICES PLLC ” Practice Location

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