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General NPI Number Information
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NPI Number | 1639045263
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Entity Type | Organization
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Legal Business Name | MOOD HAUS THERAPY, PLLC
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Dates
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Enumeration Date | 10/13/2025
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 219 N 5TH ST
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City | PEKIN
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State | IL
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Zip | 61554-3307
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Country | US
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Telephone | 815-878-6706
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Fax |
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Provider Business Mailing Address
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Address Line | 219 N 5TH ST
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City | PEKIN
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State | IL
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Zip | 61554-3307
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Country | US
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Telephone | 815-878-6706
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CORTNIE IRBY
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Credential | LCSW
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Telephone | 309-226-9479
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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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