Confidential Crisis Consultation Inc
Organization Active NPI Professional Counselor · Midlothian, IL
NPI 1356587315 · NPPES record last updated Dec 22, 2008
Key facts
- NPI
- 1356587315
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 180004220 (IL)
- Legal business name
- CONFIDENTIAL CRISIS CONSULTATION INC
- Practice address
- 4722 147TH St
Suite 11
Midlothian, IL 60445-2590 - Phone
- (708) 307-0922
- Fax
- (708) 933-0950
- NPI assigned
- Dec 22, 2008
- Organization subpart
- No
Authorized official
- Name
- Mary Ellen McSherry, LCPC
- Title
- President/Therapist
- Phone
- (708) 307-6534
Practitioners 2
-
Maryellen McSherry, LCPC
-
Judith G Candee, MSW, LCSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110627000085 | IL | Part B Supplier - Clinic/Group Practice | 5496933269 |
Receives reassigned benefits from 1 practitioner Practice locations: Oak Forest, IL |
National Provider Directory
Locations
4722 147th St
Ste 11
Midlothian, IL 60445
Phone (708) 307-0922
4722 147th St
Ste 13
Midlothian, IL 60445
Phone (708) 307-0922
5320 159th St
Ste 4021
Oak Forest, IL 60452
Phone (708) 307-6534
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor |
101YP2500X | 180004220 | IL | Yes |
Addresses
Primary practice location
4722 147TH St
Suite 11
Midlothian, IL 60445-2590
Mailing address
4722 147TH St
Suite 11
Midlothian, IL 60445-2590
Phone (708) 307-0922
Other providers in Midlothian, IL
- Heather Ann Casey
- Brandon Catledge
- Kathleen Chaudhari
- Shannon Clancy
- Stephanie Clifton
- Brenna Maureen Conlon
- Cope Optometrics, Inc
- Lauren Czochara
- Teresa Dixon-Jones
- Nicole Mae Dubin
All providers in Midlothian, IL · Professional Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 22, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.