Provider Demographics
NPI:1447754262
Name:NICK MCDOANLD COUNSELLING SERVICES INCORPORATED
Entity Type:Organization
Organization Name:NICK MCDOANLD COUNSELLING SERVICES INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:708-663-2249
Mailing Address - Street 1:11423 S NATOMA AVE
Mailing Address - Street 2:
Mailing Address - City:WORTH
Mailing Address - State:IL
Mailing Address - Zip Code:60482-2131
Mailing Address - Country:US
Mailing Address - Phone:708-663-2249
Mailing Address - Fax:
Practice Address - Street 1:552 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6658
Practice Address - Country:US
Practice Address - Phone:708-663-2249
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-19
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.010333101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty