Provider Demographics
NPI:1053713917
Name:ANN JAMES COUNSELING, LLC
Entity type:Organization
Organization Name:ANN JAMES COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:CATHERINE KNUTSON
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:779-423-0275
Mailing Address - Street 1:1639 N ALPINE RD STE 204
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-1481
Mailing Address - Country:US
Mailing Address - Phone:779-423-0275
Mailing Address - Fax:
Practice Address - Street 1:1639 N ALPINE RD STE 204
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-1481
Practice Address - Country:US
Practice Address - Phone:779-423-0275
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-23
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0118811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty