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General NPI Number Information
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NPI Number | 1669260659
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Entity Type | Organization
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Legal Business Name | BEACON COUNSELING AND WELLNESS LLC
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Dates
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Enumeration Date | 04/29/2025
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 201 PARK PL STE 2
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City | BOURBONNAIS
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State | IL
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Zip | 60914-1883
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Country | US
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Telephone | 815-219-4270
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Fax | 815-219-4275
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Provider Business Mailing Address
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Address Line | 201 PARK PL STE 2
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City | BOURBONNAIS
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State | IL
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Zip | 60914-1883
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Country | US
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Telephone | 815-219-4270
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Fax | 815-219-4275
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Authorized Official
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Title or Position | OWNER/CLINICAL DIRECTOR
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Name | MR. CHRISTOPHER DIGIOVANNI
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Credential | LCSW, CADC
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Telephone | 815-219-4270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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