Provider Demographics
NPI:1528513322
Name:NEW DIRECTION ADVOCACY AND THERAPEUTIC CONSULTANT, NFP
Entity type:Organization
Organization Name:NEW DIRECTION ADVOCACY AND THERAPEUTIC CONSULTANT, NFP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, SOCIAL SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:WORMELY
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:630-660-6145
Mailing Address - Street 1:5549 ALLEMONG DR
Mailing Address - Street 2:
Mailing Address - City:MATTESON
Mailing Address - State:IL
Mailing Address - Zip Code:60443-1101
Mailing Address - Country:US
Mailing Address - Phone:630-660-6145
Mailing Address - Fax:
Practice Address - Street 1:5549 ALLEMONG DR
Practice Address - Street 2:
Practice Address - City:MATTESON
Practice Address - State:IL
Practice Address - Zip Code:60443-1101
Practice Address - Country:US
Practice Address - Phone:630-660-6145
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-22
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.011665251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health