=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316886005
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ABOUT BEHAVIORAL CHANGE, LTD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/26/2026
-----------------------------------------------------
Last Update Date | 03/26/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 761 STATE ROUTE 31
-----------------------------------------------------
City | WEST DUNDEE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60118-2108
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-791-4384
-----------------------------------------------------
Fax | 847-426-5384
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 761 STATE ROUTE 31
-----------------------------------------------------
City | WEST DUNDEE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60118-2108
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-791-4384
-----------------------------------------------------
Fax | 847-426-5384
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | MARY CRICK
-----------------------------------------------------
Credential | LCSW. CSADC
-----------------------------------------------------
Telephone | 847-791-4384
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------