Healthcare Provider Details

I. General information

NPI: 1316886005
Provider Name (Legal Business Name): ABOUT BEHAVIORAL CHANGE, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

761 STATE ROUTE 31
WEST DUNDEE IL
60118-2108
US

IV. Provider business mailing address

761 STATE ROUTE 31
WEST DUNDEE IL
60118-2108
US

V. Phone/Fax

Practice location:
  • Phone: 847-791-4384
  • Fax: 847-426-5384
Mailing address:
  • Phone: 847-791-4384
  • Fax: 847-426-5384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MARY CRICK
Title or Position: DIRECTOR
Credential: LCSW. CSADC
Phone: 847-791-4384