Provider Demographics
NPI:1487935029
Name:ABOUT CHANGE COUNSELING
Entity type:Organization
Organization Name:ABOUT CHANGE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:IDERAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:847-668-8969
Mailing Address - Street 1:1532 WEATHERSTONE LN
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-2019
Mailing Address - Country:US
Mailing Address - Phone:847-668-8969
Mailing Address - Fax:847-488-1401
Practice Address - Street 1:1532 WEATHERSTONE LN
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-2019
Practice Address - Country:US
Practice Address - Phone:847-668-8969
Practice Address - Fax:847-488-1401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health