Organization
YOUTH & FAMILY COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANELLE MILLER MORAVEK (EXECUTIVE DIRECTOR)
(847) 748-0375
Entity
Organization
Contact information
Practice address
1113 S MILWAUKEE AVE STE 104, LIBERTYVILLE, IL 60048-3759
(847) 367-5991
(224) 300-4956
Mailing address
1113 S MILWAUKEE AVE STE 104, LIBERTYVILLE, IL 60048-3759
(847) 367-5991
(224) 300-4956
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
08/17/2022
Last updated
09/07/2022
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