Provider Demographics
NPI:1003324369
Name:CODUTO COUNSELING GROUP, P.C.
Entity Type:Organization
Organization Name:CODUTO COUNSELING GROUP, P.C.
Other - Org Name:CHRISTINA CODUTO, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CODUTO
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:630-656-7995
Mailing Address - Street 1:262 BENNETT DR
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-3349
Mailing Address - Country:US
Mailing Address - Phone:630-656-7995
Mailing Address - Fax:
Practice Address - Street 1:2100 MANCHESTER RD
Practice Address - Street 2:BLDG C STE 1618
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-4788
Practice Address - Country:US
Practice Address - Phone:630-923-5800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-19
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.008175101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty