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General NPI Number Information
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NPI Number | 1548151186
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Entity Type | Organization
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Legal Business Name | HOLISTIC COUNSELING & DEVELOPMENTAL SERVICES LLC
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Dates
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Enumeration Date | 07/11/2025
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Last Update Date | 03/11/2026
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Provider Practice Location Address
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Address Line | 246 E JANATA BLVD STE 111
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City | LOMBARD
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State | IL
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Zip | 60148-5317
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Country | US
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Telephone | 708-901-0003
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Fax |
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Provider Business Mailing Address
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Address Line | 246 E JANATA BLVD STE 111
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City | LOMBARD
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State | IL
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Zip | 60148-5317
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Country | US
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Telephone | 708-698-0714
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | MISS MICHELLE GLYNISE MOORE
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Credential | DT LMSW LCSW
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Telephone | 708-698-0714
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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