Provider Demographics
NPI:1104926625
Name:CONSULTING PROFESSIONALS INC
Entity type:Organization
Organization Name:CONSULTING PROFESSIONALS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICAH
Authorized Official - Middle Name:K
Authorized Official - Last Name:SWANSEY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:708-747-0981
Mailing Address - Street 1:PO BOX 495
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60425-0495
Mailing Address - Country:US
Mailing Address - Phone:708-747-0981
Mailing Address - Fax:
Practice Address - Street 1:593 BURNHAM AVE
Practice Address - Street 2:
Practice Address - City:CALUMET CITY
Practice Address - State:IL
Practice Address - Zip Code:60409-4031
Practice Address - Country:US
Practice Address - Phone:708-832-1002
Practice Address - Fax:708-832-1099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-24
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071006944103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209572Medicare ID - Type UnspecifiedLCSW
IL203584Medicare ID - Type UnspecifiedCLINICAL PSYCHOLOGIST