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General NPI Number Information
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NPI Number | 1730863754
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Entity Type | Organization
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Legal Business Name | BLOCK COUNSELING SERVICES
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Dates
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Enumeration Date | 06/12/2023
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Last Update Date | 06/12/2023
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Provider Practice Location Address
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Address Line | 6732 NANTUCKET CT
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City | GURNEE
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State | IL
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Zip | 60031-4014
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Country | US
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Telephone | 224-572-3328
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Fax |
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Provider Business Mailing Address
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Address Line | 6732 NANTUCKET CT
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City | GURNEE
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State | IL
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Zip | 60031-4014
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Country | US
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Telephone | 224-572-3328
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Fax |
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Authorized Official
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Title or Position | COUNSELOR, MENTAL HEALTH
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Name | LISA S. BLOCK
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Credential | LCPC
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Telephone | 847-485-9608
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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