Provider Demographics
NPI:1306985296
Name:ADVANCED COUNSELING AND ASSESSMENT SERVICES INC
Entity type:Organization
Organization Name:ADVANCED COUNSELING AND ASSESSMENT SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:CATHERINE
Authorized Official - Last Name:WISE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:815-360-3159
Mailing Address - Street 1:2208 WEBER RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:CREST HILL
Mailing Address - State:IL
Mailing Address - Zip Code:60403-0961
Mailing Address - Country:US
Mailing Address - Phone:815-630-3159
Mailing Address - Fax:815-666-1310
Practice Address - Street 1:2208 WEBER RD
Practice Address - Street 2:SUITE B
Practice Address - City:CREST HILL
Practice Address - State:IL
Practice Address - Zip Code:60403-0961
Practice Address - Country:US
Practice Address - Phone:815-630-3159
Practice Address - Fax:815-666-1310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.007866103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty