Organization Name: | ADVANCED COUNSELING AND ASSESSMENT SERVICES INC |
NPI Number: | 1306985296 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOAN CATHERINE WISE (THERAPIST) |
Mailing Address: | 2208 Weber Rd Suite B Crest Hill |
State: | IL US |
Postal Code: | 604030961 |
Phone Number: | 8156303159 |
Fax Number: | 8156661310 |
NPI Enumeration Date: | 02/06/2007 |
NPI Last Update Date: | 05/22/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 071.007866 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |