Provider Demographics
NPI:1659743631
Name:DREXEL COUNSELING SERVICES, INC.
Entity Type:Organization
Organization Name:DREXEL COUNSELING SERVICES, INC.
Other - Org Name:HARDIN HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:HARDIN
Authorized Official - Last Name:EARL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-731-5395
Mailing Address - Street 1:936 E 93RD ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60619-7814
Mailing Address - Country:US
Mailing Address - Phone:773-731-5395
Mailing Address - Fax:773-336-5545
Practice Address - Street 1:936 E 93RD ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60619-7814
Practice Address - Country:US
Practice Address - Phone:773-731-5395
Practice Address - Fax:773-336-5545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-29
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical LaboratoryGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1679846919OtherBEHAVIORAL HEALTH
IL201070243001Medicaid