Provider Demographics
NPI:1487403077
Name:CARDINAL CLINICAL COUNSELING LLC
Entity type:Organization
Organization Name:CARDINAL CLINICAL COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LEAD CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BALESKIE
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:910-382-9258
Mailing Address - Street 1:1019 LANGLEY CIR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-2023
Mailing Address - Country:US
Mailing Address - Phone:910-382-9258
Mailing Address - Fax:
Practice Address - Street 1:28379 DAVIS PKWY STE 801
Practice Address - Street 2:
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-3032
Practice Address - Country:US
Practice Address - Phone:630-277-9397
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty