Organization
COMMUNITY COUNSELING AND WELLNESS SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILIP A KIRK LCPC (OWNER)
(815) 933-0667
Entity
Organization
Contact information
Practice address
525 E NORTH ST, SUITE B, BRADLEY, IL 60915-1185
(815) 933-0667
(815) 933-0665
Mailing address
525 E NORTH ST, SUITE B, BRADLEY, IL 60915-1185
(815) 933-0667
(815) 933-0665
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
180007481
IL
Other
Enumeration date
02/27/2012
Last updated
02/27/2012
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