Healthcare Provider Details

I. General information

NPI: 1184274672
Provider Name (Legal Business Name): PERKS OF THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2019
Last Update Date: 09/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7650 S MICHIGAN AVE
CHICAGO IL
60619-2313
US

IV. Provider business mailing address

7650 S MICHIGAN AVE
CHICAGO IL
60619-2313
US

V. Phone/Fax

Practice location:
  • Phone: 773-354-5962
  • Fax:
Mailing address:
  • Phone: 773-354-5962
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: TIFFANY PERKINS
Title or Position: OWNER
Credential: LCPC
Phone: 773-354-5962