Provider Demographics
NPI:1699749416
Name:ISENBERG AND ASSOCIATES
Entity type:Organization
Organization Name:ISENBERG AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:LARSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:630-355-8410
Mailing Address - Street 1:236 S WASHINGTON ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-5371
Mailing Address - Country:US
Mailing Address - Phone:630-355-8410
Mailing Address - Fax:630-355-8412
Practice Address - Street 1:236 S WASHINGTON ST
Practice Address - Street 2:SUITE 200
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-5371
Practice Address - Country:US
Practice Address - Phone:630-355-8410
Practice Address - Fax:630-355-8412
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DUNHAM COUNSELING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-02-16
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490006601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL344510Medicare ID - Type Unspecified