Organization
OUTREACH COMMUNITY MINISTRIES INC
Active
Other names
Outreach Community Counseling Center in Carol Stream, Warrenville Youth & Family Services, Wheaton Youth Outreach
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN T. LUX LCPC (DIRECTOR OF CLINICAL SERVICES)
(630) 682-1910
Entity
Organization
Contact information
Practice address
122 W LIBERTY DR, WHEATON, IL 60187-5124
(630) 682-1910
(630) 682-0655
Mailing address
373 S SCHMALE RD STE 102, CAROL STREAM, IL 60188-2771
(630) 682-1910
(630) 682-3094
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02232105
BLUE CROSS BLUE SHIELD
IL
Enumeration date
08/31/2006
Last updated
01/15/2021
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