Healthcare Provider Details

I. General information

NPI: 1093626855
Provider Name (Legal Business Name): PERSEVERANCE POINT COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2026
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1580 N NORTHWEST HWY STE 319F
PARK RIDGE IL
60068-1444
US

IV. Provider business mailing address

1580 N NORTHWEST HWY STE 319F
PARK RIDGE IL
60068-1444
US

V. Phone/Fax

Practice location:
  • Phone: 847-238-2452
  • Fax:
Mailing address:
  • Phone: 847-238-2452
  • 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: MICHAEL J RUSSELL II
Title or Position: PRESIDENT
Credential: LCPC
Phone: 847-238-2452