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General NPI Number Information
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NPI Number | 1205102043
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Entity Type | Organization
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Legal Business Name | TRUTH AND GRACE COUNSELING, LLC
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Dates
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Enumeration Date | 03/27/2012
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Last Update Date | 03/27/2012
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Provider Practice Location Address
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Address Line | 461 BRIARGATE DR
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City | SOUTH ELGIN
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State | IL
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Zip | 60177-2225
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Country | US
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Telephone | 224-578-5548
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Fax | 847-301-0911
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Provider Business Mailing Address
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Address Line | 835 GREGORY LN
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City | SCHAUMBURG
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State | IL
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Zip | 60193-3916
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Country | US
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Telephone | 224-578-5548
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Fax | 847-301-0911
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | MS. KAREN MARIE BRIDWELL
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Credential | LCPC
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Telephone | 224-578-5548
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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 | 248000554
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License Number State | IL
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