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General NPI Number Information
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NPI Number | 1801544820
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Entity Type | Organization
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Legal Business Name | FIREWEED COUNSELING, INC.
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Dates
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Enumeration Date | 03/17/2022
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Last Update Date | 03/17/2022
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Provider Practice Location Address
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Address Line | 3380 LACROSSE LN STE 98
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City | NAPERVILLE
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State | IL
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Zip | 60564-8520
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Country | US
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Telephone | 630-728-8469
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Fax |
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Provider Business Mailing Address
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Address Line | 580 SETH ST
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City | BOLINGBROOK
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State | IL
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Zip | 60440-9043
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Country | US
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Telephone | 630-728-8469
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/COUNSELOR
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Name | RACHAEL EGGE
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Credential | LCPC
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Telephone | 630-728-8469
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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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