Provider Demographics
NPI:1508260175
Name:OLIMENE COUNSELING SERVICES, INC.
Entity Type:Organization
Organization Name:OLIMENE COUNSELING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:KARA
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIMENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-275-0748
Mailing Address - Street 1:440 W BOUGHTON RD STE B
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-2394
Mailing Address - Country:US
Mailing Address - Phone:331-318-8181
Mailing Address - Fax:
Practice Address - Street 1:440 W BOUGHTON RD STE B
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-2394
Practice Address - Country:US
Practice Address - Phone:888-542-2119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-10
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490104401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF400263245Medicare PIN