Organization
CLINICAL ASSOCIATES IN COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHARON A. WIERENGA L.C.P.C. (MANAGER)
(708) 254-8999
Entity
Organization
Contact information
Practice address
15030 S RAVINIA AVE, SUITE 30, ORLAND PARK, IL 60462-3256
(708) 254-8999
Mailing address
11253 S DEPOT ST, WORTH, IL 60482-1812
(708) 254-8999
(708) 361-5552
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180-005274
IL
101YP2500X
Professional Counselor
180-006390
IL
101YP2500X
Professional Counselor
180-006728
IL
103TC0700X
Clinical Psychologist
071-003846
IL
Other
Enumeration date
06/09/2009
Last updated
06/09/2009
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