Provider Demographics
NPI:1811597875
Name:BODHI COUNSELING, LLC
Entity Type:Organization
Organization Name:BODHI COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCHICHT
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:815-514-8935
Mailing Address - Street 1:2318 CARPENTER AVE
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60586-5126
Mailing Address - Country:US
Mailing Address - Phone:708-825-4394
Mailing Address - Fax:833-833-0317
Practice Address - Street 1:15201 S ROUTE 59
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-2681
Practice Address - Country:US
Practice Address - Phone:815-514-8935
Practice Address - Fax:833-833-0317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)