Provider Demographics
NPI:1255492443
Name:COMMUNITY MENTAL HEALTH COUNCIL INC.
Entity Type:Organization
Organization Name:COMMUNITY MENTAL HEALTH COUNCIL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, MANAGED CARE
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:I
Authorized Official - Credentials:MA
Authorized Official - Phone:773-734-4033
Mailing Address - Street 1:7330 S MERRILL AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60649-3209
Mailing Address - Country:US
Mailing Address - Phone:773-447-2589
Mailing Address - Fax:
Practice Address - Street 1:8704 S CONSTANCE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60617-2746
Practice Address - Country:US
Practice Address - Phone:773-734-4033
Practice Address - Fax:773-731-9695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty