Provider Demographics
NPI:1598139719
Name:P.R. MINENGER, LLC
Entity Type:Organization
Organization Name:P.R. MINENGER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CHIEF CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:MINENGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-671-1082
Mailing Address - Street 1:605 N MICHIGAN AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3141
Mailing Address - Country:US
Mailing Address - Phone:312-671-1082
Mailing Address - Fax:
Practice Address - Street 1:605 N MICHIGAN AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3141
Practice Address - Country:US
Practice Address - Phone:312-671-1082
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-26
Last Update Date:2015-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty