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General NPI Number Information
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NPI Number | 1548704901
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Entity Type | Organization
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Legal Business Name | BEGIN WITHIN COUNSELING & COACHING SERVICES, INC.
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Dates
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Enumeration Date | 12/05/2016
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Last Update Date | 12/05/2016
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Provider Practice Location Address
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Address Line | 115 N MARION ST SUITE 6
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City | OAK PARK
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State | IL
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Zip | 60301-1503
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Country | US
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Telephone | 708-870-6255
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Fax |
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Provider Business Mailing Address
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Address Line | 629 S TAYLOR AVE
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City | OAK PARK
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State | IL
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Zip | 60304-1621
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Country | US
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Telephone | 708-870-6255
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | ADDIE W ANDERSON
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Credential | LCPC
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Telephone | 708-870-6255
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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 | 180.005782
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License Number State | IL
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