Provider Demographics
NPI:1639343700
Name:ACACIA CLINICAL COUNSELING, P.C.
Entity Type:Organization
Organization Name:ACACIA CLINICAL COUNSELING, P.C.
Other - Org Name:NONE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:NORTON-JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:630-981-7497
Mailing Address - Street 1:535 S WASHINGTON ST
Mailing Address - Street 2:STE. #1
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-6795
Mailing Address - Country:US
Mailing Address - Phone:630-981-7497
Mailing Address - Fax:
Practice Address - Street 1:535 S WASHINGTON ST
Practice Address - Street 2:STE. #1
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6795
Practice Address - Country:US
Practice Address - Phone:630-981-7497
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-18
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health