Provider Demographics
NPI:1043612443
Name:INTEGRITY CLINICAL CONSULTING & TRAINING LLC
Entity Type:Organization
Organization Name:INTEGRITY CLINICAL CONSULTING & TRAINING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KRISTA
Authorized Official - Middle Name:G
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:708-794-6511
Mailing Address - Street 1:900 RIDGE RD
Mailing Address - Street 2:SUITE 1SW
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-1933
Mailing Address - Country:US
Mailing Address - Phone:708-794-6511
Mailing Address - Fax:708-249-0022
Practice Address - Street 1:900 RIDGE RD
Practice Address - Street 2:SUITE 1SW
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-1933
Practice Address - Country:US
Practice Address - Phone:708-794-6511
Practice Address - Fax:708-249-0022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-17
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-0138391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1730368208OtherINDIVIDUAL NPI