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Organization
PRA BEHAVIORAL LLC
Active
Organization
PRA BEHAVIORAL LLC
Active
Other names
PRA Psychiatric Group
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA MAZLIACH COMM MA LCPC (PRACTICE ADMINISTRATOR)
(847) 240-2211
Entity
Organization
Contact information
Practice address
1701 E WOODFIELD RD, SUITE 1000, SCHAUMBURG, IL 60173
(847) 240-2211
(847) 240-2418
Mailing address
1701 E WOODFIELD RD, SUITE 1000, SCHAUMBURG, IL 60173-5113
(847) 240-2211
(847) 240-2418
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1633897
BCBS GROUP NUMBER
IL
01
—
512571
VALUE OPTIONS GRP #
IL
Enumeration date
02/08/2006
Last updated
09/04/2018
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