Healthcare Provider Details

I. General information

NPI: 1821114794
Provider Name (Legal Business Name): ASSOCIATES IN COUNSELING & PSYCHOTHERAPY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 06/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 N ROCK RUN DR SUITE 22
CREST HILL IL
60435-3153
US

IV. Provider business mailing address

1520 N ROCK RUN DR SUITE 22
CREST HILL IL
60435-3153
US

V. Phone/Fax

Practice location:
  • Phone: 815-730-8900
  • Fax: 815-730-0988
Mailing address:
  • Phone: 815-730-8900
  • Fax: 815-730-0988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MRS. ALEXANDRIA PRISCO
Title or Position: EXECUTIVE DIRECTOR
Credential: LCPC
Phone: 815-730-8900