Provider Demographics
NPI:1083474688
Name:COUNSEL PSYCHOTHERAPY & COACHING PLLC
Entity Type:Organization
Organization Name:COUNSEL PSYCHOTHERAPY & COACHING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:ANSELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:616-481-2054
Mailing Address - Street 1:422 S MAIN ST # 3002
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-2600
Mailing Address - Country:US
Mailing Address - Phone:616-481-2054
Mailing Address - Fax:
Practice Address - Street 1:414 N PARK BLVD
Practice Address - Street 2:
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-4602
Practice Address - Country:US
Practice Address - Phone:616-481-2054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty