Provider Demographics
NPI:1922555630
Name:BARBARA ORTIZ COUNSELING LLC
Entity type:Organization
Organization Name:BARBARA ORTIZ COUNSELING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LCPC
Authorized Official - Phone:217-443-1966
Mailing Address - Street 1:10 RIDGEVIEW ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:DANVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61832-1410
Mailing Address - Country:US
Mailing Address - Phone:217-443-1966
Mailing Address - Fax:217-443-7013
Practice Address - Street 1:10 RIDGEVIEW ST
Practice Address - Street 2:SUITE A
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832-1410
Practice Address - Country:US
Practice Address - Phone:217-443-1966
Practice Address - Fax:217-443-7013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-10
Last Update Date:2016-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.006719101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty