Provider Demographics
NPI:1104831999
Name:OMAN & OMAN COUNSELING, INC.
Entity Type:Organization
Organization Name:OMAN & OMAN COUNSELING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:A
Authorized Official - Last Name:OMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPHIL, LCPC
Authorized Official - Phone:815-639-9405
Mailing Address - Street 1:5055 SPRING CREEK RD
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61114-6325
Mailing Address - Country:US
Mailing Address - Phone:815-639-9405
Mailing Address - Fax:815-639-9407
Practice Address - Street 1:5055 SPRING CREEK RD
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61114-6325
Practice Address - Country:US
Practice Address - Phone:815-639-9405
Practice Address - Fax:815-639-9407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X, 101YP2500X, 101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL10121002OtherBLUE CROSS BLUE SHIELD