Provider Demographics
NPI:1942670120
Name:CAREY COUNSELING
Entity Type:Organization
Organization Name:CAREY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:CAREY
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:815-520-2303
Mailing Address - Street 1:483 N MULFORD RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-5191
Mailing Address - Country:US
Mailing Address - Phone:815-703-7542
Mailing Address - Fax:866-516-7056
Practice Address - Street 1:483 N MULFORD RD
Practice Address - Street 2:SUITE 4
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-5191
Practice Address - Country:US
Practice Address - Phone:815-703-7542
Practice Address - Fax:866-516-7056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-01
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.007230101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty