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General NPI Number Information
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NPI Number | 1104947928
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Entity Type | Organization
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Legal Business Name | ALL TYPES COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9944 S ROBERTS RD STE 208
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City | PALOS HILLS
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State | IL
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Zip | 60465-1558
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Country | US
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Telephone | 708-599-4220
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Fax |
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Provider Business Mailing Address
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Address Line | 9944 S ROBERTS RD STE 208
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City | PALOS HILLS
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State | IL
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Zip | 60465-1558
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Country | US
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Telephone | 708-599-4220
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. BRENDA RENE COPELAND
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Credential | CADC
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Telephone | 708-599-4220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 23367
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License Number State | IL
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