Cottage Clinic Counseling, Inc. in Bourbonnais - Clinical Child & Adolescent
Cottage Clinic Counseling, Inc. - NPI 1063604262
Cottage Clinic Counseling, Inc. is a Clinical Child & Adolescent in Bourbonnais, Illinois. Cottage Clinic Counseling, Inc. practices all healthcare services and medical treatments related to Clinical Child & Adolescent. The NPI Number for Cottage Clinic Counseling, Inc. is 1063604262. The last update date is 2007-08-13.
Cottage Clinic Counseling, Inc.'s current location address is 115 Mooney Dr, Bourbonnais, Illinois. You can contact this provider via phone number 8159328443 and fax number 8159361295. The mailing address for Cottage Clinic Counseling, Inc. is 115 Mooney Dr, Bourbonnais, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Cottage Clinic Counseling, Inc. |
|---|---|
| Address | 115 Mooney Dr, Bourbonnais, Illinois |
| Phone Number | 8159328443 |
| Fax Number | 8159361295 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | LICENSED C |
|---|---|
| Authorized Official Name | Digiacomo V. Sharon |
| Credentials | PSY.D. |
| Telephone Number | 8159328443 |
NPI Number Detail
| NPI Number | 1063604262 |
|---|---|
| Provider Enumeration Date | 2007-08-13 |
| Last Updated Date | 2007-08-13 |
Provider Mailing Address Detail
| Address | 115 Mooney Dr |
|---|---|
| City | Bourbonnais |
| State | Illinois (IL) |
| Post Code | 609142147 |
| Phone Number | 8159328443 |
| Fax Number | 8159361295 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical Child & Adolescent |
|---|---|
| Taxonomy | 103Tc2200X |
|
Definition: A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology |
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What is the unique 10-digit identification code issued to Cottage Clinic Counseling, Inc. by the Centers for Medicare & Medicaid Services?
The Cottage Clinic Counseling, Inc. has been assigned the NPI (National Provider Identifier) 1063604262 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you provide the complete physical address where Cottage Clinic Counseling, Inc. is located?
The Cottage Clinic Counseling, Inc. is situated at the following address: 115 Mooney Dr, Bourbonnais, IL, 609142147.
What is Cottage Clinic Counseling, Inc.'s specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Cottage Clinic Counseling, Inc. is Clinical Child & Adolescent, and the taxonomy code that classifies this field of practice is 103Tc2200X.
On what date was the 1063604262 assigned to Cottage Clinic Counseling, Inc.?
The Cottage Clinic Counseling, Inc. was issued its 1063604262 on 2007-08-13, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the Cottage Clinic Counseling, Inc.'s details last updated?
The information pertaining to the Cottage Clinic Counseling, Inc., including its address, specialty, and other details, was most recently updated on 2007-08-13.