Provider Demographics
NPI:1801370200
Name:COUNSELING WITH PURPOSE LLC
Entity Type:Organization
Organization Name:COUNSELING WITH PURPOSE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMULLIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:815-905-1029
Mailing Address - Street 1:961 RIDGEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-8381
Mailing Address - Country:US
Mailing Address - Phone:815-905-1029
Mailing Address - Fax:
Practice Address - Street 1:7115 VIRGINIA RD STE 104
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-3110
Practice Address - Country:US
Practice Address - Phone:815-905-1029
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty