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General NPI Number Information
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NPI Number | 1659962777
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Entity Type | Organization
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Legal Business Name | NAPERVILLE COUNSELING CENTER
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Dates
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Enumeration Date | 02/01/2021
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Last Update Date | 02/01/2021
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Provider Practice Location Address
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Address Line | 2132 DEEP WATER LN STE 216
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City | NAPERVILLE
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State | IL
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Zip | 60564-8569
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Country | US
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Telephone | 630-590-9522
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Fax |
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Provider Business Mailing Address
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Address Line | 582 COLCHESTER DR
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City | OSWEGO
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State | IL
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Zip | 60543-5208
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Country | US
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Telephone | 708-601-1185
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR/PSYCHOTHERAPIST
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Name | KELLY LAPORTE
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Credential | LCPC, NCC, CADC
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Telephone | 630-590-9522
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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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