Provider Demographics
NPI:1508181793
Name:STANEK AND ASSOCIATES COUNCELING SERVICE
Entity Type:Organization
Organization Name:STANEK AND ASSOCIATES COUNCELING SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:JON
Authorized Official - Last Name:STANEK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:708-924-1327
Mailing Address - Street 1:7808 AMELIA CT
Mailing Address - Street 2:SUITE 3B
Mailing Address - City:JUSTICE
Mailing Address - State:IL
Mailing Address - Zip Code:60458-1393
Mailing Address - Country:US
Mailing Address - Phone:708-924-1327
Mailing Address - Fax:708-924-1328
Practice Address - Street 1:1127 S MANNHEIM RD
Practice Address - Street 2:SUITE 312
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-2570
Practice Address - Country:US
Practice Address - Phone:708-924-1327
Practice Address - Fax:708-924-1328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-31
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1800000630101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty