Provider Demographics
NPI:1659912988
Name:PEAK MENTAL HEALTH COUNSELING LLC
Entity Type:Organization
Organization Name:PEAK MENTAL HEALTH COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:ASZODI
Authorized Official - Last Name:DUCHIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:812-320-3616
Mailing Address - Street 1:654 KINCAID ST
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-5038
Mailing Address - Country:US
Mailing Address - Phone:812-320-3616
Mailing Address - Fax:
Practice Address - Street 1:601 SKOKIE BLVD STE 207
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-2818
Practice Address - Country:US
Practice Address - Phone:812-320-3616
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-08
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty