Provider Demographics
NPI:1578007175
Name:CEDAR TREE COUNSELING, LTD
Entity Type:Organization
Organization Name:CEDAR TREE COUNSELING, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:J
Authorized Official - Last Name:HANLON
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:630-397-1900
Mailing Address - Street 1:12 S 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-2208
Mailing Address - Country:US
Mailing Address - Phone:630-397-1900
Mailing Address - Fax:
Practice Address - Street 1:12 S 7TH AVE
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-2208
Practice Address - Country:US
Practice Address - Phone:630-397-1900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-15
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL166001005106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty