Provider Demographics
NPI:1164792982
Name:PEACE OF MIND PLLC
Entity Type:Organization
Organization Name:PEACE OF MIND PLLC
Other - Org Name:A PEACE OF MIND, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SAHTOUT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:815-325-4977
Mailing Address - Street 1:PO BOX 7174
Mailing Address - Street 2:
Mailing Address - City:ROMEOVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60446-7074
Mailing Address - Country:US
Mailing Address - Phone:815-325-4977
Mailing Address - Fax:
Practice Address - Street 1:349 S WEBER RD
Practice Address - Street 2:
Practice Address - City:ROMEOVILLE
Practice Address - State:IL
Practice Address - Zip Code:60446-6530
Practice Address - Country:US
Practice Address - Phone:815-325-4977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-10
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490129331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty