Provider Demographics
NPI:1104583160
Name:AKA COUNSELING CENTER LLC
Entity type:Organization
Organization Name:AKA COUNSELING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALYA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABBED
Authorized Official - Suffix:
Authorized Official - Credentials:MA LCPC
Authorized Official - Phone:309-287-3583
Mailing Address - Street 1:3121 RIDGE CREST DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61704-8307
Mailing Address - Country:US
Mailing Address - Phone:309-807-8669
Mailing Address - Fax:
Practice Address - Street 1:706 OGLESBY AVE STE 114A
Practice Address - Street 2:
Practice Address - City:NORMAL
Practice Address - State:IL
Practice Address - Zip Code:61761-4616
Practice Address - Country:US
Practice Address - Phone:309-807-8669
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-23
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty