Provider Demographics
NPI:1770250649
Name:DEEPER INSIGHT COUNSELING SERVICES PC
Entity Type:Organization
Organization Name:DEEPER INSIGHT COUNSELING SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:AUGUSTINE
Authorized Official - Last Name:NSIMBI
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:708-490-7572
Mailing Address - Street 1:1820 RIDGE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-1748
Mailing Address - Country:US
Mailing Address - Phone:708-490-7572
Mailing Address - Fax:708-585-6222
Practice Address - Street 1:1820 RIDGE RD STE 200
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-1748
Practice Address - Country:US
Practice Address - Phone:630-886-5823
Practice Address - Fax:708-585-6222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-27
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty