Provider Demographics
NPI:1497361315
Name:LIVE OUT LOUD COUNSELING SERVICES PLLC
Entity Type:Organization
Organization Name:LIVE OUT LOUD COUNSELING SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:WHETSTINE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:708-825-6037
Mailing Address - Street 1:830 E HIGGINS RD STE 104H
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4792
Mailing Address - Country:US
Mailing Address - Phone:708-825-6037
Mailing Address - Fax:708-515-4471
Practice Address - Street 1:830 E HIGGINS RD STE 104H
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4792
Practice Address - Country:US
Practice Address - Phone:708-825-6037
Practice Address - Fax:708-515-4471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty