Healthcare Provider Details

I. General information

NPI: 1053861989
Provider Name (Legal Business Name): LIFESKILLS COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2016
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 MARTIN AVE
NAPERVILLE IL
60540-6536
US

IV. Provider business mailing address

230 MARTIN AVE
NAPERVILLE IL
60540-6536
US

V. Phone/Fax

Practice location:
  • Phone: 630-848-1200
  • Fax: 630-848-1208
Mailing address:
  • Phone: 630-848-1200
  • Fax: 630-848-1208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: SYED JAFRY
Title or Position: DIRECTOR
Credential: MS, MBA
Phone: 847-890-1441