1225785330 NPI number — TRUE COUNSELING AND CONSULTING SERVICES PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225785330 NPI number — TRUE COUNSELING AND CONSULTING SERVICES PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRUE COUNSELING AND CONSULTING SERVICES PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225785330
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/24/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1717 W KIRBY AVE # 372
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHAMPAIGN
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
61821-5507
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
217-776-1524
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
206 N RANDOLPH ST STE 412
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHAMPAIGN
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
61820-3978
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
217-766-1524
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/08/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MOHR
Authorized Official First Name:
EMILY
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
217-766-1524

Provider Taxonomy Codes

  • Taxonomy code: 261QM0850X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 9885 . This is a "MASSACHUSETTS BOARD OF REGISTRATION OF PSYCHOLOGISTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: PSY-203354 . This is a "STATE OF IDAHO DIVISION OF OCCUPATIONAL AND PROFESSIONAL LICENSES" identifier , issued by the state of ( ID ) . This identifiers is of the category "OTHER".
  • Identifier: 071010343 . This is a "STATE OF ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".