Provider Demographics
NPI:1962616904
Name:ACCESS COUNSELING CENTER
Entity type:Organization
Organization Name:ACCESS COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:EMIL
Authorized Official - Last Name:THURMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:773-419-8288
Mailing Address - Street 1:18303 ROBIN LN
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-2856
Mailing Address - Country:US
Mailing Address - Phone:773-419-8288
Mailing Address - Fax:708-799-1889
Practice Address - Street 1:330 W. 177TH STREET
Practice Address - Street 2:SUITE 3F
Practice Address - City:HAZEL CREST
Practice Address - State:IL
Practice Address - Zip Code:60430
Practice Address - Country:US
Practice Address - Phone:798-408-9125
Practice Address - Fax:708-799-1889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-0077531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL55900COtherPSYCHEALTH
IL784444000OtherMAGELLAN
IL12278316OtherMULTIPLAN
IL9367411OtherPHCS PRIVATE HEALTH CARE
IL1634964OtherBLUE CROSS BLUE SHIELD
IL316653OtherMHN MANAGED HEALTH NETWOR
IL521834OtherVALUEOPTIONS
ILT9190OtherAPS
IL9367411OtherPHCS PRIVATE HEALTH CARE