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General NPI Number Information
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NPI Number | 1659912988
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Entity Type | Organization
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Legal Business Name | PEAK MENTAL HEALTH COUNSELING LLC
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Dates
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Enumeration Date | 10/08/2019
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Last Update Date | 10/08/2019
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Provider Practice Location Address
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Address Line | 601 SKOKIE BLVD STE 207
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City | NORTHBROOK
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State | IL
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Zip | 60062-2818
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Country | US
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Telephone | 812-320-3616
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Fax |
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Provider Business Mailing Address
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Address Line | 654 KINCAID ST
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City | HIGHLAND PARK
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State | IL
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Zip | 60035-5038
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Country | US
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Telephone | 812-320-3616
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | MICHELLE ASZODI DUCHIN
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Credential | LCSW
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Telephone | 812-320-3616
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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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