Provider Demographics
NPI:1831428473
Name:WHEATON COUSELING CENTER
Entity type:Organization
Organization Name:WHEATON COUSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:J
Authorized Official - Last Name:REDELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:630-665-4141
Mailing Address - Street 1:200 E WILLOW AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-5463
Mailing Address - Country:US
Mailing Address - Phone:630-665-4141
Mailing Address - Fax:
Practice Address - Street 1:200 E WILLOW AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-5463
Practice Address - Country:US
Practice Address - Phone:630-665-4141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-10
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty