Organization
AWAKENINGS COUNSELING CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHOJI MARY BOLDT LCPC (OWNER/THERAPIST)
(847) 347-0688
Entity
Organization
Contact information
Practice address
111 LIONS DR, SUITE 221, BARRINGTON, IL 60010-3182
(847) 347-0688
(847) 381-1599
Mailing address
111 LIONS DR, SUITE 221, BARRINGTON, IL 60010-3182
(847) 347-0688
(847) 381-1599
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180.004697
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1245426758
NPI TYPE 1
IL
Enumeration date
06/15/2010
Last updated
06/15/2010
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