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General NPI Number Information
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NPI Number | 1417780867
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Entity Type | Organization
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Legal Business Name | VIVERE COUNSELING
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Dates
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Enumeration Date | 08/21/2024
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Last Update Date | 08/21/2024
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Provider Practice Location Address
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Address Line | 121 FAIRFIELD WAY STE 102
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-1555
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Country | US
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Telephone | 630-946-9500
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Fax | 630-597-2848
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Provider Business Mailing Address
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Address Line | PO BOX 6224
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-6224
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Country | US
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Telephone | 630-946-9500
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Fax |
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Authorized Official
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Title or Position | LCPC
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Name | KATHLEEN VALENTINO
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Credential | LCPC
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Telephone | 630-946-9500
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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 |
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License Number State |
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