Provider Demographics
NPI:1215392147
Name:TLB COUNSELING LTD
Entity Type:Organization
Organization Name:TLB COUNSELING LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:TORRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BENSON-PRYOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-322-6310
Mailing Address - Street 1:2113 TIMBERLINE TRL
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:IL
Mailing Address - Zip Code:60098-8759
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:134 CASS ST
Practice Address - Street 2:B
Practice Address - City:WOODSTOCK
Practice Address - State:IL
Practice Address - Zip Code:60098-3208
Practice Address - Country:US
Practice Address - Phone:815-322-6310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-18
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490162001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL12617889OtherCAQH