Basic Information
| Provider Information | |||||||||
| NPI: | 1316674872 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RESONANCE THERAPY AND COUNSELING SERVICES PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1509 WAUKEGAN RD # 1013 | ||||||||
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| City: | GLENVIEW | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600252122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7738446706 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2752 WOODBINE AVE | ||||||||
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| City: | EVANSTON | ||||||||
| State: | IL | ||||||||
| PostalCode: | 602011566 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7738446706 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2022 | ||||||||
| LastUpdateDate: | 08/04/2022 | ||||||||
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| AuthorizedOfficialLastName: | WOLFF | ||||||||
| AuthorizedOfficialFirstName: | GENEVIEVE | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER/MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 7738446706 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | LCPC | ||||||||
| NPICertificationDate: | 08/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.