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Organization
TABULARASA INTEGRATIVE HEALTH INC
Active
Organization
TABULARASA INTEGRATIVE HEALTH INC
Active
Other names
TRWC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIM BARKUS LCPC, CADC, CCTP-II (PARTNER)
(224) 430-8109
Entity
Organization
Contact information
Practice address
135 N GREENLEAF ST STE 120, GURNEE, IL 60031-3334
(224) 430-8109
Mailing address
135 N GREENLEAF ST STE 120, GURNEE, IL 60031-3334
(224) 285-0728
(224) 249-4411
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285384248
—
IL
05
—
342760608001
—
IL
Enumeration date
03/24/2022
Last updated
12/03/2024
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