Provider Demographics
NPI:1538785399
Name:VITA OPTIMUM COUNSELING AND CONSULTING, LLC
Entity type:Organization
Organization Name:VITA OPTIMUM COUNSELING AND CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:872-216-5549
Mailing Address - Street 1:5600 N RIVER RD STE 800
Mailing Address - Street 2:
Mailing Address - City:ROSEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60018-5166
Mailing Address - Country:US
Mailing Address - Phone:872-216-5549
Mailing Address - Fax:
Practice Address - Street 1:5600 N RIVER RD STE 800
Practice Address - Street 2:
Practice Address - City:ROSEMONT
Practice Address - State:IL
Practice Address - Zip Code:60018-5166
Practice Address - Country:US
Practice Address - Phone:872-216-5549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-17
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty