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General NPI Number Information
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NPI Number | 1124804729
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Entity Type | Organization
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Legal Business Name | THAYER COUNSELING, LTD
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Dates
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Enumeration Date | 09/07/2023
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Last Update Date | 09/07/2023
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Provider Practice Location Address
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Address Line | 512 W BURLINGTON AVE STE 3
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City | LA GRANGE
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State | IL
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Zip | 60525-2225
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Country | US
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Telephone | 312-351-4061
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Fax |
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Provider Business Mailing Address
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Address Line | 514 N WAIOLA AVE
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City | LA GRANGE PARK
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State | IL
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Zip | 60526-5528
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Country | US
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Telephone | 312-351-4061
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Fax |
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Authorized Official
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Title or Position | OWNER/PSYCHOTHERAPIST
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Name | ALISON THAYER
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Credential | LCPC
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Telephone | 312-351-4061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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