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:
Authorized official contact:
Name: Goreham, Alexander James LCSW, CRADC, EMDR-II
Phone: (331) 903-0283
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1346816402 | NPPES |
| Illinois | MEDICAID | 149018949 |
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