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General NPI Number Information
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NPI Number | 1821774571
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Entity Type | Organization
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Legal Business Name | YOUTH & FAMILY COUNSELING
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Dates
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Enumeration Date | 06/27/2023
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | 2 E ROLLINS RD STE 203
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City | ROUND LAKE BEACH
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State | IL
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Zip | 60073-3809
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Country | US
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Telephone | 847-367-5991
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Fax | 847-996-1511
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Provider Business Mailing Address
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Address Line | 1113 S MILWAUKEE AVE STE 104
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City | LIBERTYVILLE
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State | IL
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Zip | 60048-3759
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Country | US
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Telephone | 847-367-5991
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JANELLE MILLER MORAVEK
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Credential |
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Telephone | 847-748-0375
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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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 | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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