Provider Demographics
NPI:1639523558
Name:ETHOS COUNSELING GROUP, LIMITED
Entity Type:Organization
Organization Name:ETHOS COUNSELING GROUP, LIMITED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:KRUSE
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC, NCC
Authorized Official - Phone:630-457-7176
Mailing Address - Street 1:2210 MIDWEST RD
Mailing Address - Street 2:SUITE 213
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1280
Mailing Address - Country:US
Mailing Address - Phone:630-828-8120
Mailing Address - Fax:
Practice Address - Street 1:2210 MIDWEST RD
Practice Address - Street 2:SUITE 213
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1280
Practice Address - Country:US
Practice Address - Phone:630-457-7176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-17
Last Update Date:2017-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180007649101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty