Healthcare Provider Details

I. General information

NPI: 1508799263
Provider Name (Legal Business Name): THERAPY WITH ERAN, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

913 S LOGAN ST # 31
LENA IL
61048-9205
US

IV. Provider business mailing address

913 S LOGAN ST # 31
LENA IL
61048-9205
US

V. Phone/Fax

Practice location:
  • Phone: 815-242-2493
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ERAN M SMITH
Title or Position: MANAGER/OWNER
Credential: LCPC
Phone: 815-242-2493