Healthcare Provider Details

I. General information

NPI: 1821774571
Provider Name (Legal Business Name): YOUTH & FAMILY COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2023
Last Update Date: 02/28/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 E ROLLINS RD STE 203
ROUND LAKE BEACH IL
60073-3809
US

IV. Provider business mailing address

1113 S MILWAUKEE AVE STE 104
LIBERTYVILLE IL
60048-3759
US

V. Phone/Fax

Practice location:
  • Phone: 847-367-5991
  • Fax: 847-996-1511
Mailing address:
  • Phone: 847-367-5991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
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

VIII. Authorized Official

Name: JANELLE MILLER MORAVEK
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 847-748-0375