# NIKI PRUGH LMFT INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295322493
- **Authorized official:** KIMBERLY NICCOLE PRUGH LMFT (OWNER/MARRIAGE AND FAMILY THERAPIST)
- **Authorized official phone:** (773) 474-9082

## Contact information

- **Practice address:** 4425 W HOLLYWOOD AVE, CHICAGO, IL 60646-5903
- **Practice address phone:** (773) 474-9082
- **Mailing address:** 4425 W HOLLYWOOD AVE, CHICAGO, IL 60646-5903
- **Mailing address phone:** (773) 474-9082

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 12/22/2020
- **Last updated:** 12/22/2020