Healthcare Provider Details

I. General information

NPI: 1104159631
Provider Name (Legal Business Name): NEXT STEPS COUNSELING AND CONSULTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2009
Last Update Date: 09/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10101 N. ILLINOIS ROUTE 47
HUNTLEY IL
60142
US

IV. Provider business mailing address

PO BOX 234
HUNTLEY IL
60142-0234
US

V. Phone/Fax

Practice location:
  • Phone: 847-669-8580
  • Fax:
Mailing address:
  • Phone: 847-669-8580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number071-07480
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number071-07480
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number071-07480
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number071-07480
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number071-07480
License Number StateIL
# 6
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number071-07480
License Number StateIL
# 7
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number071-07480
License Number StateIL

VIII. Authorized Official

Name: DR. PATRICIA M KOLTUN
Title or Position: OWNER
Credential: PSY.D.
Phone: 847-669-8580