Healthcare Provider Details
I. General information
NPI: 1740589738
Provider Name (Legal Business Name): COMPREHENSIVE COUNSELING P C
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/16/2011
Last Update Date: 04/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1920 S HIGHLAND AVE SUITE 300-10
LOMBARD IL
60148-4988
US
IV. Provider business mailing address
1920 S HIGHLAND AVE SUITE 300-10
LOMBARD IL
60148-4988
US
V. Phone/Fax
- Phone: 630-792-1343
- Fax: 630-576-5553
- Phone: 630-792-1343
- Fax: 630-576-5553
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
SCOTT
ALLEN
DOLLINGER
Title or Position: CEO
Credential: PSY.D.
Phone: 630-792-1343