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General NPI Number Information
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NPI Number | 1598139719
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Entity Type | Organization
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Legal Business Name | P.R. MINENGER, LLC
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Dates
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Enumeration Date | 11/26/2015
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Last Update Date | 11/26/2015
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Provider Practice Location Address
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Address Line | 605 N MICHIGAN AVE SUITE 400
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City | CHICAGO
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State | IL
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Zip | 60611-3141
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Country | US
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Telephone | 312-671-1082
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Fax |
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Provider Business Mailing Address
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Address Line | 605 N MICHIGAN AVE SUITE 400
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City | CHICAGO
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State | IL
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Zip | 60611-3141
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Country | US
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Telephone | 312-671-1082
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Fax |
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Authorized Official
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Title or Position | FOUNDER/CHIEF CONSULTANT
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Name | PRISCILLA MINENGER
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Credential |
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Telephone | 312-671-1082
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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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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Taxonomy #4
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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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