Provider Demographics
NPI:1790981934
Name:FAMILY COUNSELING INSTITUTE
Entity Type:Organization
Organization Name:FAMILY COUNSELING INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NATHANIEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:GILHAM
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:708-225-1237
Mailing Address - Street 1:900 E 162ND ST
Mailing Address - Street 2:SUITE 211
Mailing Address - City:SOUTH HOLLAND
Mailing Address - State:IL
Mailing Address - Zip Code:60473-2471
Mailing Address - Country:US
Mailing Address - Phone:708-225-1237
Mailing Address - Fax:708-225-1338
Practice Address - Street 1:900 E 162ND ST
Practice Address - Street 2:SUITE 211
Practice Address - City:SOUTH HOLLAND
Practice Address - State:IL
Practice Address - Zip Code:60473-2471
Practice Address - Country:US
Practice Address - Phone:708-225-1237
Practice Address - Fax:708-225-1338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-25
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180001558101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty