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General NPI Number Information
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NPI Number | 1528294451
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Entity Type | Organization
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Legal Business Name | FAMILIES MATTER BEHAVIORAL HEALTH, INC.
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Dates
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Enumeration Date | 06/05/2009
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Last Update Date | 06/05/2009
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Provider Practice Location Address
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Address Line | 2 MID AMERICA PLZ SUITE 800
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City | OAKBROOK TERRACE
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State | IL
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Zip | 60181-4451
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Country | US
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Telephone | 630-932-7679
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Fax | 630-691-0901
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Provider Business Mailing Address
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Address Line | 2 MID AMERICA PLZ SUITE 800
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City | OAKBROOK TERRACE
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State | IL
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Zip | 60181-4451
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Country | US
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Telephone | 630-932-7679
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Fax | 630-691-0901
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Authorized Official
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Title or Position | CLINICAL DIRECTOR/PRACTITIONER
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Name | MS. DEA MARIE JOHNSON
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Credential | LCSW
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Telephone | 630-932-7679
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 18153
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149010064
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License Number State | IL
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