Provider Demographics
NPI:1437663275
Name:COUNSELING RESOURCE INSTITUTE LLC
Entity type:Organization
Organization Name:COUNSELING RESOURCE INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:J
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:BA, CPC
Authorized Official - Phone:708-560-6653
Mailing Address - Street 1:2422 E WASHINGTON ST STE 107
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61704-1611
Mailing Address - Country:US
Mailing Address - Phone:309-530-7758
Mailing Address - Fax:
Practice Address - Street 1:2422 E WASHINGTON ST STE 107
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61704-1611
Practice Address - Country:US
Practice Address - Phone:309-530-7758
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-30
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180002594101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty