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General NPI Number Information
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NPI Number | 1992240204
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Entity Type | Organization
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Legal Business Name | STAFFORD COUNSELING, INC
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Dates
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Enumeration Date | 12/21/2016
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Last Update Date | 12/21/2016
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Provider Practice Location Address
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Address Line | 1809 N MILL ST STE B
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City | NAPERVILLE
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State | IL
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Zip | 60563-1288
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Country | US
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Telephone | 630-606-6743
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Fax |
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Provider Business Mailing Address
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Address Line | 1809 N MILL ST STE B
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City | NAPERVILLE
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State | IL
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Zip | 60563-1288
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Country | US
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Telephone | 630-606-6743
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Fax |
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Authorized Official
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Title or Position | CLINICAL PROFESSIONAL COUNSELOR
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Name | MS. CYNTHIA M STAFFORD
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Credential | LCPC
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Telephone | 630-606-6743
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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 | 180001516
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License Number State | IL
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