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General NPI Number Information
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NPI Number | 1427914837
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Entity Type | Organization
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Legal Business Name | ANDREA DESATNICK COUNSELING, PLLC
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Dates
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Enumeration Date | 12/30/2025
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 5016 N UNIVERSITY ST STE 101
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City | PEORIA
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State | IL
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Zip | 61614-4763
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Country | US
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Telephone | 309-306-1206
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Fax |
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Provider Business Mailing Address
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Address Line | 1405 W TETON DR APT 7
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City | PEORIA
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State | IL
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Zip | 61614-1742
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PSYCHOTHERAPIST
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Name | ANDREA DESATNICK
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Credential | LCPC
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Telephone | 309-306-1206
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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