Provider Demographics
NPI:1508154584
Name:CLS COMPREHENSIVE SERVICES, LLC
Entity Type:Organization
Organization Name:CLS COMPREHENSIVE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/LCPC
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:LATRISE
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:NCC, LCPC, BCPCC
Authorized Official - Phone:708-481-4257
Mailing Address - Street 1:19624 GOVERNORS HWY
Mailing Address - Street 2:
Mailing Address - City:FLOSSMOOR
Mailing Address - State:IL
Mailing Address - Zip Code:60422-2077
Mailing Address - Country:US
Mailing Address - Phone:708-481-4257
Mailing Address - Fax:708-481-4254
Practice Address - Street 1:19630 GOVERNORS HWY STE 8
Practice Address - Street 2:
Practice Address - City:FLOSSMOOR
Practice Address - State:IL
Practice Address - Zip Code:60422-2079
Practice Address - Country:US
Practice Address - Phone:708-481-4257
Practice Address - Fax:708-481-4254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-12
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 101YP2500X, 101YS0200X, 261QM0850X, 261QM0855X
IL180.007522251S00000X
IL180007522251S00000X
ILCS10850909P252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Multi-Specialty
No252Y00000XAgenciesEarly Intervention Provider Agency
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2236851OtherCOMPSYCH BEHAVIORAL HEALTH
IL426416OtherMILITARY HEALTH NETWORK