Provider Demographics
NPI:1972676567
Name:RASIDI CONSULTING ASSOCIATES INC
Entity Type:Organization
Organization Name:RASIDI CONSULTING ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR OFFICE MANGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:C
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:708-331-4101
Mailing Address - Street 1:17076 S PARK AVE
Mailing Address - Street 2:17076 SOUTH PARK AVE SUITE L
Mailing Address - City:SOUTH HOLLAND
Mailing Address - State:IL
Mailing Address - Zip Code:60473-3349
Mailing Address - Country:US
Mailing Address - Phone:708-331-4101
Mailing Address - Fax:708-331-4755
Practice Address - Street 1:17076 S PARK AVE
Practice Address - Street 2:17076 SOUTH PARK AVE SUITE L
Practice Address - City:SOUTH HOLLAND
Practice Address - State:IL
Practice Address - Zip Code:60473-3349
Practice Address - Country:US
Practice Address - Phone:708-331-4101
Practice Address - Fax:708-331-4755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-005780101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty