Provider Demographics
NPI:1245710821
Name:NEXUS COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:NEXUS COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/LCPC
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:773-357-6361
Mailing Address - Street 1:1756 BURR OAK RD
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-1811
Mailing Address - Country:US
Mailing Address - Phone:773-771-7138
Mailing Address - Fax:
Practice Address - Street 1:1800 RIDGE RD STE 3
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-1723
Practice Address - Country:US
Practice Address - Phone:773-357-6361
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180011166101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty