Healthcare Provider Details

I. General information

NPI: 1972427490
Provider Name (Legal Business Name): BUILDING BRIDGES COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 S. MAIN STREET
BOURBONNAIS IL
60914-2345
US

IV. Provider business mailing address

340 S. MAIN STREET
BOURBONNAIS IL
60914-2345
US

V. Phone/Fax

Practice location:
  • Phone: 815-474-4007
  • Fax:
Mailing address:
  • Phone: 815-314-0537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL

VIII. Authorized Official

Name: AMY FORBES
Title or Position: THERAPIST
Credential: LCPC
Phone: 815-474-4007