Provider Demographics
NPI:1073680765
Name:OPTIONS EAP
Entity Type:Organization
Organization Name:OPTIONS EAP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRYANN
Authorized Official - Middle Name:
Authorized Official - Last Name:DUMYAHN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:815-879-0327
Mailing Address - Street 1:PO BOX 116
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:IL
Mailing Address - Zip Code:61356-0116
Mailing Address - Country:US
Mailing Address - Phone:815-879-0327
Mailing Address - Fax:815-875-1720
Practice Address - Street 1:300 BACKBONE ROAD E
Practice Address - Street 2:SUITE 3
Practice Address - City:PRINCETON
Practice Address - State:IL
Practice Address - Zip Code:61356-2073
Practice Address - Country:US
Practice Address - Phone:815-879-0327
Practice Address - Fax:815-875-1720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490067731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty