Provider Demographics
NPI:1558499020
Name:MCINNES COUNSELING SERVICES INC
Entity Type:Organization
Organization Name:MCINNES COUNSELING SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MCINNES
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:815-933-7887
Mailing Address - Street 1:110 MOONEY DR
Mailing Address - Street 2:STE.#1
Mailing Address - City:BOURBONNAIS
Mailing Address - State:IL
Mailing Address - Zip Code:60914-2171
Mailing Address - Country:US
Mailing Address - Phone:815-933-7887
Mailing Address - Fax:815-933-7870
Practice Address - Street 1:110 MOONEY DR
Practice Address - Street 2:STE.#1
Practice Address - City:BOURBONNAIS
Practice Address - State:IL
Practice Address - Zip Code:60914-2171
Practice Address - Country:US
Practice Address - Phone:815-933-7887
Practice Address - Fax:815-933-7870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-001816101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty