Provider Demographics
NPI:1922399682
Name:COUNSELORS ASSOCIATES
Entity type:Organization
Organization Name:COUNSELORS ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:618-972-3191
Mailing Address - Street 1:3 OAK DR STE B
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62062-5635
Mailing Address - Country:US
Mailing Address - Phone:618-972-1568
Mailing Address - Fax:618-205-3561
Practice Address - Street 1:3 OAK DR STE B
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62062-5635
Practice Address - Country:US
Practice Address - Phone:618-972-1568
Practice Address - Fax:618-205-3561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-28
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180007781101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty