Provider Demographics
NPI:1992239396
Name:ONWARD COUNSELING CENTER
Entity type:Organization
Organization Name:ONWARD COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:BRISTOW
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:847-924-0261
Mailing Address - Street 1:888 E BELVIDERE RD
Mailing Address - Street 2:STE 319
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-2568
Mailing Address - Country:US
Mailing Address - Phone:847-924-0261
Mailing Address - Fax:
Practice Address - Street 1:888 E BELVIDERE RD
Practice Address - Street 2:STE 319
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-2568
Practice Address - Country:US
Practice Address - Phone:847-924-0261
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-12
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty