Provider Demographics
NPI:1164987533
Name:COUNSELING CENTER OF ARLINGTON HEIGHTS, LLC
Entity Type:Organization
Organization Name:COUNSELING CENTER OF ARLINGTON HEIGHTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:NOWAK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CADC, JD
Authorized Official - Phone:847-767-4719
Mailing Address - Street 1:3205 N WILKE RD STE 103C
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-0001
Mailing Address - Country:US
Mailing Address - Phone:847-767-4719
Mailing Address - Fax:
Practice Address - Street 1:3205 N WILKE RD STE 103C
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-0001
Practice Address - Country:US
Practice Address - Phone:847-767-4719
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-09
Last Update Date:2019-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty