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General NPI Number Information
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NPI Number | 1932613320
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Entity Type | Organization
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Legal Business Name | KANE COUNTY COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 11/22/2017
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 311 N 2ND ST STE 201D
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City | SAINT CHARLES
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State | IL
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Zip | 60174-1852
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Country | US
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Telephone | 630-797-9192
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Fax |
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Provider Business Mailing Address
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Address Line | 311 N 2ND ST STE 201D
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City | SAINT CHARLES
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State | IL
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Zip | 60174-1852
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Country | US
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Telephone | 630-797-9192
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ALISHA R BARNUM
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Credential | LCPC
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Telephone | 630-797-9192
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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 | 180.010472
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License Number State | IL
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