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Organization

REVIVE COUNSELING LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GUADALUPE MAYA-VESKOVIC LCSW (FOUNDER)
(773) 609-1758
Entity
Organization

Contact information

Practice address
8052 MONTICELLO AVE UNIT 103, SKOKIE, IL 60076-3438
(773) 609-1758
Mailing address
4188 COVE LN APT C, GLENVIEW, IL 60025-3561

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1669986915
SELF-PAY, COMMERCIAL INSURANCE
IL
Enumeration date
08/31/2021
Last updated
08/31/2021
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