Provider Demographics
NPI:1629402698
Name:GORENZ COUNSELING AND CONSULTING LTD
Entity Type:Organization
Organization Name:GORENZ COUNSELING AND CONSULTING LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:GORENZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:815-876-6285
Mailing Address - Street 1:1009 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:IL
Mailing Address - Zip Code:61356-2434
Mailing Address - Country:US
Mailing Address - Phone:815-872-2273
Mailing Address - Fax:815-875-1267
Practice Address - Street 1:1009 S MAIN ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:IL
Practice Address - Zip Code:61356-2434
Practice Address - Country:US
Practice Address - Phone:815-872-2273
Practice Address - Fax:815-875-1267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL4271101YA0400X
IL180001089101YP2500X
IL1490025821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty