Provider Demographics
NPI:1508235540
Name:ADVOCACY COUNSELING CENTER, LTD
Entity Type:Organization
Organization Name:ADVOCACY COUNSELING CENTER, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:WERTHEIMER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:815-243-6789
Mailing Address - Street 1:44 N VIRGINIA ST
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-4106
Mailing Address - Country:US
Mailing Address - Phone:815-243-6789
Mailing Address - Fax:
Practice Address - Street 1:44 N VIRGINIA ST
Practice Address - Street 2:SUITE 2B
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-4106
Practice Address - Country:US
Practice Address - Phone:815-243-6789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-21
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071005699103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty