Provider Demographics
NPI:1851019665
Name:YOUTH & FAMILY COUNSELING
Entity Type:Organization
Organization Name:YOUTH & FAMILY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JANELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER MORAVEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-748-0375
Mailing Address - Street 1:1113 S MILWAUKEE AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-3759
Mailing Address - Country:US
Mailing Address - Phone:847-367-5991
Mailing Address - Fax:224-300-4956
Practice Address - Street 1:1113 S MILWAUKEE AVE STE 104
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-3759
Practice Address - Country:US
Practice Address - Phone:847-367-5991
Practice Address - Fax:224-300-4956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-17
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health