Provider Demographics
NPI:1861173866
Name:RESILIENT LIFE COUNSELING AND CONSULTING PLLC
Entity type:Organization
Organization Name:RESILIENT LIFE COUNSELING AND CONSULTING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ANNEMARIE
Authorized Official - Middle Name:KATHERINE
Authorized Official - Last Name:HUSSER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LCPC
Authorized Official - Phone:779-704-0931
Mailing Address - Street 1:455 COVENTRY LN STE 105
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-7570
Mailing Address - Country:US
Mailing Address - Phone:779-704-0931
Mailing Address - Fax:
Practice Address - Street 1:455 COVENTRY LN STE 105
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-7570
Practice Address - Country:US
Practice Address - Phone:779-704-0931
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-31
Last Update Date:2024-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1013160506OtherNPI TYPE 1