Healthcare Provider Details

I. General information

NPI: 1992599625
Provider Name (Legal Business Name): CENTERED VILLAGE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2025
Last Update Date: 02/09/2026
Certification Date: 02/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 TOWER RD
SCHAUMBURG IL
60173-4309
US

IV. Provider business mailing address

1320 TOWER RD
SCHAUMBURG IL
60173-4309
US

V. Phone/Fax

Practice location:
  • Phone: 480-572-2491
  • Fax:
Mailing address:
  • Phone: 480-572-2491
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. LORA PROIA
Title or Position: OWNER/LCPC
Credential: NCC, LCPC, LPC, PEL
Phone: 480-572-2491