Provider Demographics
NPI:1477918886
Name:ALDERSON FAMILY CONNECTIONS, PC
Entity Type:Organization
Organization Name:ALDERSON FAMILY CONNECTIONS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CLINICAL SOCIAL WORKER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:708-990-6090
Mailing Address - Street 1:16162 ELLIS AVE # 1N
Mailing Address - Street 2:
Mailing Address - City:SOUTH HOLLAND
Mailing Address - State:IL
Mailing Address - Zip Code:60473-1700
Mailing Address - Country:US
Mailing Address - Phone:708-990-6090
Mailing Address - Fax:708-331-9417
Practice Address - Street 1:16162 ELLIS AVE # 1N
Practice Address - Street 2:
Practice Address - City:SOUTH HOLLAND
Practice Address - State:IL
Practice Address - Zip Code:60473-1700
Practice Address - Country:US
Practice Address - Phone:708-990-6090
Practice Address - Fax:708-331-9417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-30
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
IL149.010280251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty