Fireside Counseling LLC
Counselor, Mental Health in Wheaton, IL. Organization (NPI-2).
NPI number1508258732
StatusActive
Last updated in NPPESFeb 25, 2015
Details
- NPI
- 1508258732
- Entity type
- Organization (NPI-2)
- Legal business name
- Fireside Counseling LLC
- Organization subpart
- No
- Enumeration date
- Feb 25, 2015
- Last updated
- Feb 25, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | 180000241 | IL | Yes |
Practice location
101 1/2 E Front StSuite 106
Wheaton, IL 60187-5334
Phone 630-239-7227
Mailing address
101 1/2 E Front StSuite 106
Wheaton, IL 60187-5334
Phone 630-239-7227
Authorized official
Mark L Ramirez
Sr. Staff Therapist
6302397227
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