Healthcare Provider Details

I. General information

NPI: 1013852235
Provider Name (Legal Business Name): ROAD YET TAKEN COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 N VINE ST UNIT 65
NEW LENOX IL
60451-5002
US

IV. Provider business mailing address

300 N VINE ST UNIT 65
NEW LENOX IL
60451-5002
US

V. Phone/Fax

Practice location:
  • Phone: 815-320-0620
  • Fax:
Mailing address:
  • Phone: 815-320-0620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: DOROTA TERESA KRUCZEK
Title or Position: OWNER/THERAPIST
Credential: MSW, LCSW
Phone: 708-629-8691