Provider Demographics
NPI:1063195634
Name:RESILIENT COUNSELING
Entity type:Organization
Organization Name:RESILIENT COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:CALDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:618-510-9131
Mailing Address - Street 1:PO BOX 252
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62439-0252
Mailing Address - Country:US
Mailing Address - Phone:618-510-9131
Mailing Address - Fax:217-670-6713
Practice Address - Street 1:1308 COLLINS AVE
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62439-2528
Practice Address - Country:US
Practice Address - Phone:618-510-9131
Practice Address - Fax:217-670-6713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-10
Last Update Date:2024-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty