Provider Demographics
NPI:1609314830
Name:ASSOCIATED COUNSELING, LLC
Entity Type:Organization
Organization Name:ASSOCIATED COUNSELING, LLC
Other - Org Name:ASSOCIATED COUNSELING AND WELLNESS CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:C
Authorized Official - Last Name:FRACASSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-597-0032
Mailing Address - Street 1:4500 147TH ST
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:IL
Mailing Address - Zip Code:60445-2646
Mailing Address - Country:US
Mailing Address - Phone:708-597-0032
Mailing Address - Fax:
Practice Address - Street 1:4500 147TH ST
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:IL
Practice Address - Zip Code:60445-2646
Practice Address - Country:US
Practice Address - Phone:708-597-0032
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-08
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty