Healthcare Provider Details

I. General information

NPI: 1992210322
Provider Name (Legal Business Name): PERSONAL SOLUTIONS COUNSELING, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2017
Last Update Date: 12/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20855 S. LAGRANGE RD SUITE 202
FRANKFORT IL
60423
US

IV. Provider business mailing address

20855 S. LAGRANGE RD SUITE 202
FRANKFORT IL
60423
US

V. Phone/Fax

Practice location:
  • Phone: 815-806-9300
  • Fax: 815-806-3076
Mailing address:
  • Phone: 815-806-9300
  • Fax: 815-806-3076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: BRENNA L PANARES
Title or Position: PRESIDENT
Credential: LCSW
Phone: 815-806-9300