Provider Demographics
NPI:1164624144
Name:CORE PSYCHOTHERAPY CENTER
Entity Type:Organization
Organization Name:CORE PSYCHOTHERAPY CENTER
Other - Org Name:CORE THERAPY ASSOCIATES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:H
Authorized Official - Last Name:TOMAS-TOLENTINO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:847-240-5080
Mailing Address - Street 1:1305 WILEY RD
Mailing Address - Street 2:SUITE 125
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173
Mailing Address - Country:US
Mailing Address - Phone:847-240-5080
Mailing Address - Fax:847-240-1977
Practice Address - Street 1:1701 E WOODFIELD RD
Practice Address - Street 2:SUITE 814
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-5905
Practice Address - Country:US
Practice Address - Phone:847-240-5080
Practice Address - Fax:847-240-1977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-02
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty