Provider Demographics
NPI:1679698526
Name:ACCENT COUNSELING LLC
Entity type:Organization
Organization Name:ACCENT COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:CULLOP
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:217-398-8067
Mailing Address - Street 1:1207 S MATTIS AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61821-4861
Mailing Address - Country:US
Mailing Address - Phone:217-398-8067
Mailing Address - Fax:
Practice Address - Street 1:1207 S MATTIS AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61821-4861
Practice Address - Country:US
Practice Address - Phone:217-398-8067
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL5466-0001101YA0400X
IL101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001032051OtherKATHI CULLOP BCBS