Provider Demographics
NPI:1679216469
Name:PERSONAL ENRICHMENT THERAPY LLC
Entity Type:Organization
Organization Name:PERSONAL ENRICHMENT THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JENA
Authorized Official - Middle Name:CLAUDIA
Authorized Official - Last Name:YUEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:224-366-0189
Mailing Address - Street 1:275 FERN DR
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE VILLAGE
Mailing Address - State:IL
Mailing Address - Zip Code:60007-4013
Mailing Address - Country:US
Mailing Address - Phone:224-366-0189
Mailing Address - Fax:
Practice Address - Street 1:164 DIVISION ST STE 714
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60120-5534
Practice Address - Country:US
Practice Address - Phone:224-366-0189
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-19
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty