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General NPI Number Information
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NPI Number | 1306248505
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Entity Type | Organization
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Legal Business Name | A & A CLINICAL COUNSELING SOLUTIONS, INC.
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Dates
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Enumeration Date | 09/18/2014
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Last Update Date | 09/18/2014
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Provider Practice Location Address
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Address Line | 4580 WEAVER PARKWAY SUITE 204
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City | WARRENVILLE
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State | IL
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Zip | 60555
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Country | US
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Telephone | 630-473-3970
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Fax |
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Provider Business Mailing Address
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Address Line | 292 LORRAINE CIR
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2547
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Country | US
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Telephone | 847-630-7818
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Fax |
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Authorized Official
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Title or Position | BILINGUAL PSYCHOTHERAPIST
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Name | DR. MARTHA H ANGEL
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Credential | PSY.D., LCPC
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Telephone | 847-630-7818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 180005122
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License Number State | IL
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