Healthcare Provider Details

I. General information

NPI: 1720539323
Provider Name (Legal Business Name): BR COUNSELING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2016
Last Update Date: 10/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 S LINCOLNWAY SUITE F
NORTH AURORA IL
60542-1663
US

IV. Provider business mailing address

8344 ADBETH AVE
WOODRIDGE IL
60517-4556
US

V. Phone/Fax

Practice location:
  • Phone: 630-801-1669
  • Fax: 630-801-1675
Mailing address:
  • Phone: 630-709-8350
  • Fax: 630-801-1675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number180.010312
License Number StateIL

VIII. Authorized Official

Name: MRS. BRITTANY M ROBACK
Title or Position: PRESIDENT
Credential: LCPC, CADC
Phone: 630-709-8350