Provider Demographics
NPI:1548684004
Name:OAK TREE COUNSELING LLC
Entity type:Organization
Organization Name:OAK TREE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTAL
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:573-231-0627
Mailing Address - Street 1:1012 N 24TH ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:IL
Mailing Address - Zip Code:62301-2266
Mailing Address - Country:US
Mailing Address - Phone:217-653-9084
Mailing Address - Fax:
Practice Address - Street 1:1012 N 24TH ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:IL
Practice Address - Zip Code:62301-2266
Practice Address - Country:US
Practice Address - Phone:217-653-9084
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-04
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180006735251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health