Provider Demographics
NPI:1689264913
Name:WEATHERSTONE COUNSELING INSTITUTE LLC
Entity Type:Organization
Organization Name:WEATHERSTONE COUNSELING INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/ PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIEBERT-HERETH
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:312-927-2373
Mailing Address - Street 1:1590 WEATHERSTONE LN UNIT SE
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-2059
Mailing Address - Country:US
Mailing Address - Phone:312-927-2373
Mailing Address - Fax:
Practice Address - Street 1:1590 WEATHERSTONE LN UNIT SE
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-2059
Practice Address - Country:US
Practice Address - Phone:312-927-2373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty