Provider Demographics
NPI:1942336136
Name:CLINICAL ASSOCIATES FOR MENTAL HEALTH, PC
Entity Type:Organization
Organization Name:CLINICAL ASSOCIATES FOR MENTAL HEALTH, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:WARNER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:630-279-5321
Mailing Address - Street 1:1550 SPRING RD STE 215
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1350
Mailing Address - Country:US
Mailing Address - Phone:630-279-5321
Mailing Address - Fax:
Practice Address - Street 1:1550 SPRING RD STE 215
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1350
Practice Address - Country:US
Practice Address - Phone:630-279-5321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-24
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL212450Medicare PIN