Provider Demographics
NPI:1528532363
Name:NEXT DIRECTION COUNSELING
Entity type:Organization
Organization Name:NEXT DIRECTION COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PROF COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:DAGOSTINO
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:847-208-5976
Mailing Address - Street 1:177 EVERGREEN PKWY
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-4213
Mailing Address - Country:US
Mailing Address - Phone:847-208-5976
Mailing Address - Fax:
Practice Address - Street 1:2600 BEHAN RD STE E3
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-2224
Practice Address - Country:US
Practice Address - Phone:847-208-5976
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-15
Last Update Date:2023-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health