NPI 1760811905 · live from the CMS NPI Registry
Advantage Behavioral Health
Social Worker, Clinical in Algonquin, IL. National Provider Identifier 1760811905, active.
NPI record
| NPI | 1760811905 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | 1138 N Main St, Algonquin, IL 60102 |
| Practice phone | 847-658-4224 |
| Enumerated | November 7, 2013 |
| Last updated | November 7, 2013 |
| Authorized official | Wana Durpetti, Director Of Eap Services |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | 23496 (IL) |
| Counselor, Professional | 101YP2500X | 180006721 (IL) |
| Social Worker, Clinical primary | 1041C0700X | 149008798 (IL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.