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Organization
GREEN DOOR THERAPY LLC
Active
Organization
GREEN DOOR THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BROOKE MADERA MS, LCPC, CADC (CLINICAL THERAPIST/ SUPERVISOR)
(630) 384-9560
Entity
Organization
Contact information
Practice address
126 N YORK ST STE 2, ELMHURST, IL 60126-2888
(163) 038-4956
Mailing address
PO BOX 7109, VILLA PARK, IL 60181-7109
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
05/21/2018
Last updated
11/09/2021
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