Provider Demographics
NPI:1366670150
Name:METROKA COUNSELING SERVICES, PC
Entity Type:Organization
Organization Name:METROKA COUNSELING SERVICES, PC
Other - Org Name:METROKA COACHING SERVICES, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:B
Authorized Official - Last Name:METROKA
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:847-658-6684
Mailing Address - Street 1:1301 PYOTT RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LAKE IN THE HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60156-9795
Mailing Address - Country:US
Mailing Address - Phone:847-658-6684
Mailing Address - Fax:847-458-2250
Practice Address - Street 1:1301 PYOTT RD
Practice Address - Street 2:SUITE 102
Practice Address - City:LAKE IN THE HILLS
Practice Address - State:IL
Practice Address - Zip Code:60156-9795
Practice Address - Country:US
Practice Address - Phone:847-658-6684
Practice Address - Fax:847-458-2250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-30
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL060-010227101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty