Organization
COPERTINO COUNSELING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK COPERTINO MS, LCPC (CLINICAL PROFESSIONAL COUNSELOR)
(630) 440-9013
Entity
Organization
Contact information
Practice address
526 CRESCENT BLVD, GLEN ELLYN, IL 60137-4176
(630) 440-9013
Mailing address
526 CRESCENT BLVD, GLEN ELLYN, IL 60137-4176
(630) 440-9013
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
180.009951
IL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
180.009951
IL
Other
Enumeration date
01/14/2016
Last updated
01/14/2016
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