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General NPI Number Information
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NPI Number | 1861162638
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Entity Type | Individual
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Provider Name | BENJAMIN KYLE MEILS LCPC
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Gender | Male
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Dates
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Enumeration Date | 09/14/2021
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 755 ALMAR PKWY STE A
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City | BOURBONNAIS
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State | IL
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Zip | 60914-2393
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Country | US
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Telephone | 815-315-9901
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Fax |
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Provider Business Mailing Address
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Address Line | 450 W 3RD AVE
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City | CLIFTON
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State | IL
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Zip | 60927-9300
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Country | US
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Telephone | 815-922-5275
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 178018429
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180.016902
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License Number State | IL
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