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Organization
THERAPEUTIC SERVICES
Active
Organization
THERAPEUTIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LINDA WETHERBE ED.D. (OWNER)
(847) 223-6123
Entity
Organization
Contact information
Practice address
33125 N US HIGHWAY 45, GRAYSLAKE, IL 60030-3901
(847) 223-6123
Mailing address
P O BOX 329, WILDWOOD, IL 60030-0329
(847) 223-6123
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004915117
BLUE CROSS BLUE SHIELD
IL
Enumeration date
06/07/2007
Last updated
08/22/2020
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