Organization
WOUNDED HEALERS COUNSELING SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA T HERNANDEZ (CREDENTIAL SPECIALIST)
(331) 300-5317
Entity
Organization
Contact information
Practice address
15724 S ROUTE 59 STE 106, PLAINFIELD, IL 60544-2806
(630) 557-6057
Mailing address
2404 MONTEREY DR, PLAINFIELD, IL 60586-8475
(630) 723-1006
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
345923924001
—
IL
Enumeration date
06/21/2022
Last updated
06/29/2022
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