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Organization
LEYDEN DUPAGE COUNSELING SERVICE
Active
Organization
LEYDEN DUPAGE COUNSELING SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD D CUNNINGHAM MSW,LCSW (EXECUTIVE DIRECTOR)
(630) 368-9100
Entity
Organization
Contact information
Practice address
1010 JORIE BLVD, SUITE 12, OAK BROOK, IL 60523-2215
(630) 368-9100
(630) 990-0506
Mailing address
1010 JORIE BLVD, SUITE 12, OAK BROOK, IL 60523-2215
(630) 368-9100
(630) 990-0506
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01618323
BCBS PROVIDER
IL
Enumeration date
04/10/2007
Last updated
05/06/2013
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