| Organization Name: | COTTAGE CLINIC COUNSELING, INC. |
| NPI Number: | 1063604262 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHARON V. DIGIACOMO (LICENSED CLINICAL PSYCH.; PRESIDENT) |
| Mailing Address: | 115 Mooney Dr Bourbonnais |
| State: | IL US |
| Postal Code: | 609142147 |
| Phone Number: | 8159328443 |
| Fax Number: | 8159361295 |
| NPI Enumeration Date: | 08/13/2007 |
| NPI Last Update Date: | 08/13/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC2200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical Child & Adolescent |
| Taxonomy Definition: | |