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General NPI Number Information
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NPI Number | 1679925333
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Entity Type | Organization
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Legal Business Name | DUPAGE CREATIVE COUNSELING INC.
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Dates
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Enumeration Date | 07/06/2016
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 825 N CASS AVE STE 109
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City | WESTMONT
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State | IL
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Zip | 60559-6401
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Country | US
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Telephone | 309-825-6311
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Fax | 630-791-5427
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Provider Business Mailing Address
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Address Line | 8720 COVENTRY DR
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City | WOODRIDGE
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State | IL
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Zip | 60517-7502
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Country | US
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Telephone | 309-825-6311
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RACHEL WAGNER-CANTINE
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Credential | LCPC, BC-DMT
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Telephone | 309-825-6311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | 180.008394
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 180.008394
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License Number State | IL
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