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General NPI Number Information
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NPI Number | 1487403077
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Entity Type | Organization
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Legal Business Name | CARDINAL CLINICAL COUNSELING LLC
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Dates
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Enumeration Date | 05/15/2024
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Last Update Date | 05/15/2024
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Provider Practice Location Address
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Address Line | 28379 DAVIS PKWY STE 801
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City | WARRENVILLE
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State | IL
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Zip | 60555-3032
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Country | US
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Telephone | 630-277-9397
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Fax |
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Provider Business Mailing Address
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Address Line | 1019 LANGLEY CIR
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City | NAPERVILLE
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State | IL
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Zip | 60563-2023
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Country | US
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Telephone | 910-382-9258
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Fax |
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Authorized Official
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Title or Position | OWNER/LEAD CLINICIAN
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Name | CYNTHIA BALESKIE
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Credential | LCPC
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Telephone | 910-382-9258
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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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