Provider Demographics
NPI:1568187128
Name:PROSPERITY PROFESSIONAL COUNSELING
Entity Type:Organization
Organization Name:PROSPERITY PROFESSIONAL COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAZEIKIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:224-374-7135
Mailing Address - Street 1:1590 N RAND RD STE 202
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60074-8510
Mailing Address - Country:US
Mailing Address - Phone:224-374-7135
Mailing Address - Fax:224-385-1631
Practice Address - Street 1:1590 N RAND RD STE 202
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60074-8510
Practice Address - Country:US
Practice Address - Phone:224-374-7135
Practice Address - Fax:224-385-1631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-06
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty