Provider Demographics
NPI:1205474475
Name:NEW DIRECTIONS THERAPY, LTD.
Entity type:Organization
Organization Name:NEW DIRECTIONS THERAPY, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:KLACKO
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:630-686-2015
Mailing Address - Street 1:40 E 9TH ST APT 1901
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-2152
Mailing Address - Country:US
Mailing Address - Phone:847-456-8687
Mailing Address - Fax:
Practice Address - Street 1:10725 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-3217
Practice Address - Country:US
Practice Address - Phone:630-686-2015
Practice Address - Fax:312-284-1031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-18
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty