Provider Demographics
NPI:1679548093
Name:FAMILY LIFE COUNSELORS
Entity Type:Organization
Organization Name:FAMILY LIFE COUNSELORS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:BORRELLI
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC, LMFT
Authorized Official - Phone:773-763-4999
Mailing Address - Street 1:7200 N OSCEOLA AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-4353
Mailing Address - Country:US
Mailing Address - Phone:773-763-4999
Mailing Address - Fax:773-763-0449
Practice Address - Street 1:7200 N OSCEOLA AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-4353
Practice Address - Country:US
Practice Address - Phone:773-763-4999
Practice Address - Fax:773-763-0449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty