Provider Demographics
NPI:1508452434
Name:ORANGE TREE COUNSELING AND CONSULTING, LLC
Entity type:Organization
Organization Name:ORANGE TREE COUNSELING AND CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:REAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:312-725-4088
Mailing Address - Street 1:155 N MICHIGAN AVE STE 723
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-7707
Mailing Address - Country:US
Mailing Address - Phone:312-725-4088
Mailing Address - Fax:
Practice Address - Street 1:825 CHICAGO AVE FL 2A
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-2375
Practice Address - Country:US
Practice Address - Phone:312-725-4088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-15
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1295397669Medicaid
IL1477097962Medicaid
IL1508452434Medicaid
IL322769303001Medicaid