Healthcare Provider Details

I. General information

NPI: 1700637949
Provider Name (Legal Business Name): STAND STRONG COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2024
Last Update Date: 03/27/2024
Certification Date: 03/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

899 SKOKIE BLVD
NORTHBROOK IL
60062-4019
US

IV. Provider business mailing address

1232 WOOD AVE
DEERFIELD IL
60015-2948
US

V. Phone/Fax

Practice location:
  • Phone: 312-479-4700
  • Fax:
Mailing address:
  • Phone: 312-479-4700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SARAH SODIKOFF
Title or Position: LICENSED CLINICAL SOCIAL WORKER
Credential:
Phone: 312-479-4700