Provider Demographics
NPI:1780355842
Name:BIRCHWOOD COUNSELING PLLC
Entity type:Organization
Organization Name:BIRCHWOOD COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:AINSWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:815-343-5857
Mailing Address - Street 1:380 MESSENGER CIR
Mailing Address - Street 2:
Mailing Address - City:NORTH AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60542-1805
Mailing Address - Country:US
Mailing Address - Phone:815-343-5857
Mailing Address - Fax:
Practice Address - Street 1:380 MESSENGER CIR
Practice Address - Street 2:
Practice Address - City:NORTH AURORA
Practice Address - State:IL
Practice Address - Zip Code:60542-1805
Practice Address - Country:US
Practice Address - Phone:815-343-5857
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-27
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1356481543OtherNPI