Organization
NORTHSIDE COUNSELING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN THOMPSON LCPC, LPC (PRESIDENT)
(773) 960-8359
Entity
Organization
Contact information
Practice address
20130 SAMARA TRL, LAKE ANN, MI 49650-9685
(773) 960-8359
Mailing address
20130 SAMARA TRL, LAKE ANN, MI 49650-9685
(773) 960-8359
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180000932
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001634445
BCBSIL
IL
01
—
103637507
UBH
IL
Enumeration date
11/27/2006
Last updated
06/28/2016
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