Provider Demographics
NPI:1487274569
Name:LANTZ COUNSELING AND COACHING, LLC
Entity type:Organization
Organization Name:LANTZ COUNSELING AND COACHING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAITLIN
Authorized Official - Middle Name:LUCILLE
Authorized Official - Last Name:LANTZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:815-694-0801
Mailing Address - Street 1:846 SEDGEGRASS DR
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61822-2024
Mailing Address - Country:US
Mailing Address - Phone:815-694-0801
Mailing Address - Fax:
Practice Address - Street 1:201 W SPRINGFIELD AVE STE 208
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61820-4875
Practice Address - Country:US
Practice Address - Phone:815-694-0801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-20
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty