Provider Demographics
NPI:1568607018
Name:ASPEN COUNSELING SERVICES, LTD.
Entity Type:Organization
Organization Name:ASPEN COUNSELING SERVICES, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:W
Authorized Official - Last Name:RENNARD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CSAT
Authorized Official - Phone:708-769-1509
Mailing Address - Street 1:45 S PARK BLVD STE 370
Mailing Address - Street 2:
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137-6282
Mailing Address - Country:US
Mailing Address - Phone:708-769-1509
Mailing Address - Fax:
Practice Address - Street 1:45 S PARK BLVD STE 370
Practice Address - Street 2:
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-6282
Practice Address - Country:US
Practice Address - Phone:708-769-1509
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-12
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180006436101YA0400X
IL1490096141041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty