Provider Demographics
NPI:1306248505
Name:A & A CLINICAL COUNSELING SOLUTIONS, INC.
Entity type:Organization
Organization Name:A & A CLINICAL COUNSELING SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILINGUAL PSYCHOTHERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:H
Authorized Official - Last Name:ANGEL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, LCPC
Authorized Official - Phone:847-630-7818
Mailing Address - Street 1:292 LORRAINE CIR
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-2547
Mailing Address - Country:US
Mailing Address - Phone:847-630-7818
Mailing Address - Fax:
Practice Address - Street 1:4580 WEAVER PARKWAY SUITE 204
Practice Address - Street 2:
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555
Practice Address - Country:US
Practice Address - Phone:630-473-3970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180005122103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty