Provider Demographics
NPI:1215299987
Name:CHICAGO COUNSELING ASSOCIATES
Entity type:Organization
Organization Name:CHICAGO COUNSELING ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:773-281-7200
Mailing Address - Street 1:1000 W DIVERSEY PKWY STE 275
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-1879
Mailing Address - Country:US
Mailing Address - Phone:773-281-7200
Mailing Address - Fax:773-281-7201
Practice Address - Street 1:1000 W DIVERSEY PKWY STE 275
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-1879
Practice Address - Country:US
Practice Address - Phone:773-281-7200
Practice Address - Fax:773-281-7201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-08
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-001970101YM0800X
IL178-000596101YM0800X
IL178-007170106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty