Provider Demographics
NPI:1144802794
Name:ALTERNATIVE WELLNESS THERAPIES PLLC
Entity Type:Organization
Organization Name:ALTERNATIVE WELLNESS THERAPIES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:EBERT
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:815-200-6444
Mailing Address - Street 1:9950 N ALPINE RD STE 103
Mailing Address - Street 2:
Mailing Address - City:MACHESNEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:61115-8362
Mailing Address - Country:US
Mailing Address - Phone:815-200-6444
Mailing Address - Fax:815-201-1702
Practice Address - Street 1:9950 N ALPINE RD STE 103
Practice Address - Street 2:
Practice Address - City:MACHESNEY PARK
Practice Address - State:IL
Practice Address - Zip Code:61115-8362
Practice Address - Country:US
Practice Address - Phone:815-200-6444
Practice Address - Fax:815-201-1702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-23
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty