Provider Demographics
NPI:1316576200
Name:EXISTENTIAL COUNSELOR SOCIETY
Entity Type:Organization
Organization Name:EXISTENTIAL COUNSELOR SOCIETY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BIPIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCPC
Authorized Official - Phone:708-250-0520
Mailing Address - Street 1:2319 MANHATTAN RD
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60433-8605
Mailing Address - Country:US
Mailing Address - Phone:708-223-2698
Mailing Address - Fax:708-487-0451
Practice Address - Street 1:2319 MANHATTAN RD
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60433-8605
Practice Address - Country:US
Practice Address - Phone:708-223-2698
Practice Address - Fax:708-487-0451
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EXISTENTIAL COUNSELOR SOCIET LTD.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-04-03
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health