Provider Demographics
NPI:1508105313
Name:ASPEN COUNSELING & CONSULTING
Entity Type:Organization
Organization Name:ASPEN COUNSELING & CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO / PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PHIL
Authorized Official - Middle Name:
Authorized Official - Last Name:EATON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-387-5600
Mailing Address - Street 1:1021 N MULFORD RD
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-3877
Mailing Address - Country:US
Mailing Address - Phone:815-399-9700
Mailing Address - Fax:815-316-4726
Practice Address - Street 1:1415 E STATE ST
Practice Address - Street 2:SUITE 900
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61104-2333
Practice Address - Country:US
Practice Address - Phone:815-399-9700
Practice Address - Fax:815-316-4726
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROSECRANCE HEALTH NETWORK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-02-14
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)