Provider Demographics
NPI:1770093361
Name:NORTH STAR COUNSELING GROUP, LLC
Entity type:Organization
Organization Name:NORTH STAR COUNSELING GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JORI
Authorized Official - Middle Name:
Authorized Official - Last Name:RISKE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:224-260-0688
Mailing Address - Street 1:209 E PARK ST STE B
Mailing Address - Street 2:
Mailing Address - City:MUNDELEIN
Mailing Address - State:IL
Mailing Address - Zip Code:60060-1972
Mailing Address - Country:US
Mailing Address - Phone:224-360-0688
Mailing Address - Fax:847-566-0182
Practice Address - Street 1:209 E PARK ST STE B
Practice Address - Street 2:
Practice Address - City:MUNDELEIN
Practice Address - State:IL
Practice Address - Zip Code:60060-1972
Practice Address - Country:US
Practice Address - Phone:224-360-0688
Practice Address - Fax:847-566-0182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-09
Last Update Date:2017-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty