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General NPI Number Information
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NPI Number | 1588116289
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Entity Type | Organization
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Legal Business Name | KID MATTERS COUNSELING P.C.
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Dates
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Enumeration Date | 10/28/2016
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Last Update Date | 05/04/2017
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Provider Practice Location Address
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Address Line | 201 E OGDEN AVE SUITE 106
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City | HINSDALE
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State | IL
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Zip | 60521-3633
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Country | US
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Telephone | 855-543-7687
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Fax |
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Provider Business Mailing Address
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Address Line | 201 E OGDEN AVE SUITE 106
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City | HINSDALE
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State | IL
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Zip | 60521-3633
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Country | US
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Telephone | 855-543-7687
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SUSAN M. STUTZMAN
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Credential | M.A. LCPC
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Telephone | 855-543-7687
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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 | 180010594
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License Number State | IL
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