NPI 1962616904 · live from the CMS NPI Registry
Access Counseling Center
Social Worker, Clinical in Hazel Crest, IL. National Provider Identifier 1962616904, active.
NPI record
| NPI | 1962616904 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | 330 W. 177th Street, Suite 3f, Hazel Crest, IL 60430 |
| Practice phone | 798-408-9125 |
| Mailing address | 18303 Robin Ln, Homewood, IL 60430 |
| Enumerated | May 9, 2007 |
| Last updated | June 13, 2008 |
| Authorized official | Robert Thurman, President Ceo |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Social Worker, Clinical primary | 1041C0700X | 149-007753 (IL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.