Life Redefined Clinical Counseling

LBN: Goreham Incorporated
Life Redefined Clinical Counseling is an health care organization with primary practice located at 417 W Roosevelt Rd Ste B , Wheaton IL 60187-2320. The organization recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Social Worker is the primary health care specialty. Goreham Incorporated can be contacted via phone (331) 205-8185, or through Goreham, Alexander James via phone (331) 903-0283.

Contact Information

Primary practice address
417 W Roosevelt Rd Ste B Wheaton IL 60187-2320
Phone: (331) 205-8185
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Goreham, Alexander James LCSW, CRADC, EMDR-II
Phone: (331) 903-0283

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Professional 101YP2500X
Behavioral Health & Social Service Providers / Social Worker 104100000X

Profile Details

NPI number 1346816402
LBN Legal business name Goreham Incorporated
DBA Doing business as Life Redefined Clinical Counseling
Authorized official Goreham, Alexander James LCSW, CRADC, EMDR-II
Entity Organization
Organization subpart 1 No
Enumeration date May 31st, 2021
Last updated Mar 23rd, 2022 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346816402 NPPES
Illinois MEDICAID 149018949

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