Organization
C2ACT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARJORIE DIAZ RODRIGUEZ MA (LICENSED CLINICAL SOCIAL WORKER)
(224) 210-6694
Entity
Organization
Contact information
Practice address
3417 N KENNICOTT AVE STE A, ARLINGTON HEIGHTS, IL 60004-7824
(224) 210-6694
(224) 836-5174
Mailing address
3417 N KENNICOTT AVE STE A, ARLINGTON HEIGHTS, IL 60004-7824
(224) 210-6694
(224) 836-5174
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
1041C0700X
Clinical Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
149011093
IL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
12/23/2011
Last updated
03/01/2022
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