Provider Demographics
NPI:1871347930
Name:AUTHENTIC COUNSELING AND THERAPY, PLLC
Entity type:Organization
Organization Name:AUTHENTIC COUNSELING AND THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:815-735-9108
Mailing Address - Street 1:1045 FERRARI DR
Mailing Address - Street 2:
Mailing Address - City:COAL CITY
Mailing Address - State:IL
Mailing Address - Zip Code:60416-1843
Mailing Address - Country:US
Mailing Address - Phone:815-735-9108
Mailing Address - Fax:
Practice Address - Street 1:1045 FERRARI DR
Practice Address - Street 2:
Practice Address - City:COAL CITY
Practice Address - State:IL
Practice Address - Zip Code:60416-1843
Practice Address - Country:US
Practice Address - Phone:815-735-9108
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty