Provider Demographics
NPI:1508274721
Name:PATRICK AMES COUNSELING, LLC
Entity Type:Organization
Organization Name:PATRICK AMES COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:AMES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, ACC
Authorized Official - Phone:224-639-2607
Mailing Address - Street 1:132 COOLIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-3206
Mailing Address - Country:US
Mailing Address - Phone:224-639-2607
Mailing Address - Fax:847-307-8992
Practice Address - Street 1:255 QUENTIN RD
Practice Address - Street 2:
Practice Address - City:HAWTHORN WOODS
Practice Address - State:IL
Practice Address - Zip Code:60047-1604
Practice Address - Country:US
Practice Address - Phone:224-639-2607
Practice Address - Fax:847-307-8992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP1600X
IL1490070691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty