Provider Demographics
NPI:1497893945
Name:CHARATE, AJEET S (LCPC, CADC, BCN)
Entity Type:Individual
Prefix:MR
First Name:AJEET
Middle Name:S
Last Name:CHARATE
Suffix:
Gender:M
Credentials:LCPC, CADC, BCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60432-4331
Mailing Address - Country:US
Mailing Address - Phone:815-722-4384
Mailing Address - Fax:
Practice Address - Street 1:1260 IROQUOIS AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-1689
Practice Address - Country:US
Practice Address - Phone:630-369-4152
Practice Address - Fax:630-369-4629
Is Sole Proprietor?:No
Enumeration Date:2007-02-04
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180005140101YP2500X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL180005140OtherLICENSE