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General NPI Number Information
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NPI Number | 1477386332
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Entity Type | Organization
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Legal Business Name | FAITH MOVES MOUNTAINS COUNSELING AND THERAPY LLC
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Dates
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Enumeration Date | 08/24/2024
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 228 EVELYN AVE APT 3
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City | LOVES PARK
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State | IL
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Zip | 61111-5097
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Country | US
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Telephone | 779-220-0223
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Fax | 888-668-1804
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Provider Business Mailing Address
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Address Line | 228 EVELYN AVE APT 3
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City | LOVES PARK
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State | IL
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Zip | 61111-5097
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Country | US
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Telephone | 779-220-0223
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Fax | 888-668-1804
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | TARICA RILEY
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Credential |
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Telephone | 779-220-0223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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