Provider Demographics
NPI:1407267131
Name:DREA RICHARDS COUNSELING, INC
Entity Type:Organization
Organization Name:DREA RICHARDS COUNSELING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCPC
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAITIN-RICHARDS
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:708-586-9545
Mailing Address - Street 1:119 STEPHEN ST
Mailing Address - Street 2:
Mailing Address - City:LEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60439-3660
Mailing Address - Country:US
Mailing Address - Phone:708-586-9545
Mailing Address - Fax:708-277-1722
Practice Address - Street 1:119 STEPHEN ST
Practice Address - Street 2:
Practice Address - City:LEMONT
Practice Address - State:IL
Practice Address - Zip Code:60439-3660
Practice Address - Country:US
Practice Address - Phone:708-586-9545
Practice Address - Fax:708-277-1722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-15
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180004289101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty