Organization
ACACIA ROOTS COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNA CHRISTINA CORNEJO LCSW (SOCIAL WORKER)
(708) 232-3550
Entity
Organization
Contact information
Practice address
84 E BURLINGTON ST UNIT 2, RIVERSIDE, IL 60546-2118
(708) 232-3550
Mailing address
84 E BURLINGTON ST UNIT 2, RIVERSIDE, IL 60546-2118
(708) 232-3550
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
12/14/2021
Last updated
01/12/2023
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