Provider Demographics
NPI:1609310523
Name:KARI SANDY COUNSELING CORPORATION
Entity Type:Organization
Organization Name:KARI SANDY COUNSELING CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARI
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:773-263-7796
Mailing Address - Street 1:556 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:ROSELLE
Mailing Address - State:IL
Mailing Address - Zip Code:60172-1003
Mailing Address - Country:US
Mailing Address - Phone:773-263-7796
Mailing Address - Fax:
Practice Address - Street 1:975 E NERGE RD
Practice Address - Street 2:SUITE W100-E
Practice Address - City:ROSELLE
Practice Address - State:IL
Practice Address - Zip Code:60172-4804
Practice Address - Country:US
Practice Address - Phone:773-263-7796
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-12
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490130421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty