Provider Demographics
NPI:1588459515
Name:AJDW THERAPY PLLC
Entity type:Organization
Organization Name:AJDW THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADDALINE
Authorized Official - Middle Name:J
Authorized Official - Last Name:STOLL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:331-210-8260
Mailing Address - Street 1:1815 OAK ST
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-3634
Mailing Address - Country:US
Mailing Address - Phone:331-210-8260
Mailing Address - Fax:
Practice Address - Street 1:1815 OAK ST
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-3634
Practice Address - Country:US
Practice Address - Phone:331-210-8260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty