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General NPI Number Information
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NPI Number | 1235351909
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Entity Type | Organization
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Legal Business Name | TRI COUNSELING GROUP LTD.
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5225 OLD ORCHARD ROAD SUITE 29
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City | SKOKIE
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State | IL
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Zip | 60077-1027
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Country | US
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Telephone | 847-966-8806
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Fax | 847-475-1245
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Provider Business Mailing Address
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Address Line | 5225 OLD ORCHARD ROAD SUITE 29
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City | SKOKIE
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State | IL
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Zip | 60077-1027
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Country | US
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Telephone | 847-966-8806
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Fax | 847-475-1245
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. BLAKE DOUGLAS OSBORNE
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Credential | LCSW
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Telephone | 847-966-8806
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | IL
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