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Organization
MRB COUNSELING, SC
Active
Organization
MRB COUNSELING, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL R BOURBON LCSW (PRESIDENT)
(847) 918-0129
Entity
Organization
Contact information
Practice address
977 LAKEVIEW PKWY, #155, VERNON HILLS, IL 60061-1400
(847) 918-0129
(847) 918-0747
Mailing address
977 LAKEVIEW PKWY, #155, VERNON HILLS, IL 60061-1400
(847) 918-0129
(847) 918-0747
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1632567
BCBS
IL
Enumeration date
11/22/2006
Last updated
08/22/2020
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