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General NPI Number Information
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NPI Number | 1285366591
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Entity Type | Organization
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Legal Business Name | FOREST VIEW COUNSELING SERVICES PLLC
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Dates
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Enumeration Date | 06/27/2022
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Last Update Date | 06/27/2022
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Provider Practice Location Address
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Address Line | 6975 REDANSA DR
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City | ROCKFORD
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State | IL
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Zip | 61108-1201
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Country | US
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Telephone | 815-391-0168
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Fax |
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Provider Business Mailing Address
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Address Line | 13925 CASSIDY DR
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City | ROCKTON
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State | IL
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Zip | 61072-1670
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Country | US
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Telephone | 815-391-0168
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | COLIN R GILLETTE
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Credential | LMFT
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Telephone | 815-391-0168
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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