Basic Information
| Provider Information | |||||||||
| NPI: | 1831526961 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TRUTH IN LOVE COUNSELING LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 706 OGLESBY AVE | ||||||||
| Address2: | STE. 112 | ||||||||
| City: | NORMAL | ||||||||
| State: | IL | ||||||||
| PostalCode: | 617614616 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3095850241 | ||||||||
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| Practice Location | |||||||||
| Address1: | 706 OGLESBY AVE | ||||||||
| Address2: | STE. 112 | ||||||||
| City: | NORMAL | ||||||||
| State: | IL | ||||||||
| PostalCode: | 617614616 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3095850241 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2013 | ||||||||
| LastUpdateDate: | 07/14/2014 | ||||||||
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| AuthorizedOfficialLastName: | BUSSMANN | ||||||||
| AuthorizedOfficialFirstName: | CARRIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER/LEAD THERAPIST | ||||||||
| AuthorizedOfficialTelephone: | 3095850241 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | LCPC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 178008398 | IL | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Professional | 101YP2500X | 180005335 | IL | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.