Provider Demographics
NPI:1609301639
Name:PLATT PROFESSIONAL COUNSELING, LLC
Entity Type:Organization
Organization Name:PLATT PROFESSIONAL COUNSELING, LLC
Other - Org Name:PLATT PROFESSIONAL COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LCPC, CADC
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:PLATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-269-1516
Mailing Address - Street 1:11885 ELISE BLVD
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-7989
Mailing Address - Country:US
Mailing Address - Phone:708-269-1516
Mailing Address - Fax:
Practice Address - Street 1:10217 W LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-1279
Practice Address - Country:US
Practice Address - Phone:708-269-1516
Practice Address - Fax:815-277-2106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-27
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL31894101YA0400X
IL180.009540101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty