| Organization Name: | WATERFALL COUNSELING LLC |
| NPI Number: | 1174867048 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SUSAN M JACOBOWSKI (CLINICAL SOCIAL WORKER/MANAGER) |
| Mailing Address: | 119 Stephen St Lemont |
| State: | IL US |
| Postal Code: | 604393660 |
| Phone Number: | 6302575757 |
| Fax Number: | 6302577055 |
| NPI Enumeration Date: | 11/16/2012 |
| NPI Last Update Date: | 11/16/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 149010821 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |