Provider Demographics
NPI:1669520896
Name:ANXIETY & DEPRESSION TREATMENT CENTER
Entity type:Organization
Organization Name:ANXIETY & DEPRESSION TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOLAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:630-305-0127
Mailing Address - Street 1:445 W JACKSON AVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-5256
Mailing Address - Country:US
Mailing Address - Phone:630-305-0127
Mailing Address - Fax:
Practice Address - Street 1:445 W JACKSON AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-5256
Practice Address - Country:US
Practice Address - Phone:630-305-0127
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X, 101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty