Provider Demographics
NPI:1629607833
Name:GENERATIONS THERAPY & COUNSELING
Entity Type:Organization
Organization Name:GENERATIONS THERAPY & COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEAD THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:708-351-6729
Mailing Address - Street 1:20601 PROMETHIAN WAY
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA FIELDS
Mailing Address - State:IL
Mailing Address - Zip Code:60461-1517
Mailing Address - Country:US
Mailing Address - Phone:708-351-6729
Mailing Address - Fax:708-810-6070
Practice Address - Street 1:20601 PROMETHIAN WAY
Practice Address - Street 2:
Practice Address - City:OLYMPIA FIELDS
Practice Address - State:IL
Practice Address - Zip Code:60461-1517
Practice Address - Country:US
Practice Address - Phone:708-351-6729
Practice Address - Fax:708-810-6070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-08
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty