Organization
JFSW, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RICHELLE MARIE WILLIAMS LCPC, LMFT, CADC (PRESIDENT)
(708) 488-8000
Entity
Organization
Contact information
Practice address
7627 LAKE ST STE 213, RIVER FOREST, IL 60305-1878
(708) 488-8000
Mailing address
3648 GUNDERSON AVE, BERWYN, IL 60402-3878
(708) 788-1180
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
180-003418
IL
106H00000X
Marriage & Family Therapist
Primary
166-000517
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01633354
BLUE CROSS BLUE SHIELD
IL
Enumeration date
11/22/2006
Last updated
01/28/2009
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