Provider Demographics
NPI:1053901322
Name:ENCOMPASS COUNSELING & THERAPY CORP
Entity type:Organization
Organization Name:ENCOMPASS COUNSELING & THERAPY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:JAEGER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:815-757-2743
Mailing Address - Street 1:5500 CARRIAGEWAY DR APT 203C
Mailing Address - Street 2:
Mailing Address - City:ROLLING MEADOWS
Mailing Address - State:IL
Mailing Address - Zip Code:60008-3963
Mailing Address - Country:US
Mailing Address - Phone:847-454-3051
Mailing Address - Fax:847-454-3052
Practice Address - Street 1:5500 CARRIAGEWAY DR APT 203C
Practice Address - Street 2:
Practice Address - City:ROLLING MEADOWS
Practice Address - State:IL
Practice Address - Zip Code:60008-3963
Practice Address - Country:US
Practice Address - Phone:847-454-3051
Practice Address - Fax:847-454-3052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty