Provider Demographics
NPI:1780223529
Name:OASIS COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:OASIS COUNSELING SERVICES LLC
Other - Org Name:OASIS COUNSELING SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:S
Authorized Official - Last Name:DILLON
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:219-781-1113
Mailing Address - Street 1:7956 BIRCH DR
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:IN
Mailing Address - Zip Code:46324-3329
Mailing Address - Country:US
Mailing Address - Phone:219-781-1113
Mailing Address - Fax:
Practice Address - Street 1:1314 KENSINGTON RD UNIT 4531
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60522-7136
Practice Address - Country:US
Practice Address - Phone:630-324-4996
Practice Address - Fax:219-844-0195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-26
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1730447657OtherNPI NUMBER FOR ANTHONY S DILLON
IL180008405OtherLCPC LICENSE NUMBER FOR ANTHONY S DILLON
12544682OtherCAQH PROVIDER ID NUMBER