| Brandon Douglas, Lcpc, Pllc | |
|
8 Heritage Plaza Bourbonnais IL 60914 | |
| (309) 706-4989 | |
| Not Available |
| Full Name | Brandon Douglas, Lcpc, Pllc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 8 Heritage Plaza, Bourbonnais, Illinois |
| Authorized Official Name and Position | Brandon Douglas (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 3097064989 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brandon Douglas, Lcpc, Pllc 6933 175th St Tinley Park IL 60477-3826 Ph: (309) 706-4989 | Brandon Douglas, Lcpc, Pllc 8 Heritage Plaza Bourbonnais IL 60914 Ph: (309) 706-4989 |
| NPI Number | 1538859079 |
|---|---|
| Provider Enumeration Date | 05/09/2023 |
| Last Update Date | 07/03/2023 |
| Certification Date | 07/03/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538859079 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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