Provider Demographics
NPI:1245979103
Name:BE THE BREAKTHROUGH COUNSELING SOLUTIONS LLC
Entity type:Organization
Organization Name:BE THE BREAKTHROUGH COUNSELING SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANEY
Authorized Official - Middle Name:M
Authorized Official - Last Name:STEVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:BCCC
Authorized Official - Phone:630-440-2764
Mailing Address - Street 1:3057 W 100TH ST
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60805-3506
Mailing Address - Country:US
Mailing Address - Phone:630-440-2764
Mailing Address - Fax:312-229-8845
Practice Address - Street 1:3057 W 100TH ST
Practice Address - Street 2:
Practice Address - City:EVERGREEN PARK
Practice Address - State:IL
Practice Address - Zip Code:60805-3506
Practice Address - Country:US
Practice Address - Phone:630-440-2764
Practice Address - Fax:312-229-8845
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BE FIRST BUSINESS SOLUTIONS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1831842483Medicaid