Organization
CREATING CHANGE COUNSELING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE KOHUT LCSW (OWNER)
(815) 617-9420
Entity
Organization
Contact information
Practice address
400 5TH ST STE 197, PERU, IL 61354-2876
(815) 617-9420
Mailing address
400 5TH ST STE 197, PERU, IL 61354-2876
(815) 617-9420
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
04/01/2022
Last updated
07/28/2022
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