Provider Demographics
NPI:1093117814
Name:ALL GENERATIONS COUNSELING, COACHING AND CONSULTING
Entity Type:Organization
Organization Name:ALL GENERATIONS COUNSELING, COACHING AND CONSULTING
Other - Org Name:ALL GENERATIONS
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:T
Authorized Official - Last Name:DOUGHERTY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:773-759-6829
Mailing Address - Street 1:927 SAINT JOHN ST
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60120-2937
Mailing Address - Country:US
Mailing Address - Phone:773-759-6829
Mailing Address - Fax:847-888-2883
Practice Address - Street 1:397 FULTON ST
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60120-6517
Practice Address - Country:US
Practice Address - Phone:224-377-9241
Practice Address - Fax:847-888-2883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-24
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health