Healthcare Provider Details

I. General information

NPI: 1053244467
Provider Name (Legal Business Name): FLORECEMOS THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4242 1ST AVE UNIT 1104
LYONS IL
60534-1470
US

IV. Provider business mailing address

4242 1ST AVE UNIT 1104
LYONS IL
60534-1470
US

V. Phone/Fax

Practice location:
  • Phone: 331-251-1719
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: CHANTAL PICO
Title or Position: COUNSELOR
Credential: LCPC
Phone: 331-251-1719