Healthcare Provider Details

I. General information

NPI: 1982539730
Provider Name (Legal Business Name): ON BARREN HEIGHTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 S 1ST AVE
MORTON IL
61550-2037
US

IV. Provider business mailing address

208 S 1ST AVE
MORTON IL
61550-2037
US

V. Phone/Fax

Practice location:
  • Phone: 309-613-2501
  • Fax:
Mailing address:
  • Phone: 309-613-2501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: BLAKE MUEHLICH
Title or Position: OWNER
Credential: LCPC
Phone: 309-613-2501