Provider Demographics
NPI:1659687010
Name:UNITY COUNSELING CENTER
Entity Type:Organization
Organization Name:UNITY COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM COORDINATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:DARLINE
Authorized Official - Middle Name:ANITA
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MHP
Authorized Official - Phone:708-450-1707
Mailing Address - Street 1:5870 W. LAKE STREET
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60644-3888
Mailing Address - Country:US
Mailing Address - Phone:773-261-0324
Mailing Address - Fax:708-450-1713
Practice Address - Street 1:5870 W. LAKE STREET
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60644-3888
Practice Address - Country:US
Practice Address - Phone:773-261-0324
Practice Address - Fax:708-450-1713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-24
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty