Provider Demographics
NPI:1003340779
Name:ASPIRE COUNSELING CONSULTING AND CREATIVE SOLUTIONS
Entity Type:Organization
Organization Name:ASPIRE COUNSELING CONSULTING AND CREATIVE SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JASMINE
Authorized Official - Middle Name:ALEGRA
Authorized Official - Last Name:TUDY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:847-946-5105
Mailing Address - Street 1:501 N RIVERSIDE DR
Mailing Address - Street 2:111
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-5918
Mailing Address - Country:US
Mailing Address - Phone:847-946-5105
Mailing Address - Fax:
Practice Address - Street 1:501 N RIVERSIDE DR
Practice Address - Street 2:111
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-5918
Practice Address - Country:US
Practice Address - Phone:847-946-5105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-19
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.010922101YP2500X
IL166.000785106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty