MEDICARE: CENTERPOINT COUNSELING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	149.016185	IL

General Provider Information

NPI Number	:	1841733052
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTERPOINT COUNSELING

Provider Business Mailing Address
First Line	:	8900 GRANT AVE
Second Line	:
City	:	BROOKFIELD
State	:	IL
Zip	:	60513-1608
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	125 WINDSOR DR
Second Line	:	SUITE 111
City	:	OAK BROOK
State	:	IL
Zip	:	60523-1536
Country	:	US
Telephone Number	:	708-480-2747
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOTHERAPIST
Name	:	JENNIFER GEITER
Credential	:	LCSW
Telephone Number	:	708-480-2747

Provider Enumeration Date	:	11/21/2016
Last Update Date	:	11/21/2016

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