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General NPI Number Information
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NPI Number | 1063401206
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Entity Type | Organization
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Legal Business Name | CENTRAL DUPAGE PASTORAL COUNSELING CENTER
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Dates
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Enumeration Date | 10/20/2005
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Last Update Date | 06/03/2021
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Provider Practice Location Address
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Address Line | 507 THORNHILL DR SUITE A
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City | CAROL STREAM
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State | IL
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Zip | 60188-2706
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Country | US
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Telephone | 630-752-9750
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Fax | 630-752-9768
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Provider Business Mailing Address
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Address Line | 507 THORNHILL DR SUITE A
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City | CAROL STREAM
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State | IL
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Zip | 60188-2706
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Country | US
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Telephone | 630-752-9750
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Fax | 630-752-9768
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. NANCY COCHRAN
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Credential | PSYD
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Telephone | 630-752-9750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 178002569
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071004746
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 178001992
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License Number State | IL
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Taxonomy #6
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180005369
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License Number State | IL
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Taxonomy #7
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180002208
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License Number State | IL
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Taxonomy #8
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071006345
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License Number State | IL
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Taxonomy #9
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071006372
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License Number State | IL
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Taxonomy #10
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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