Moving Mosaic Therapy & Counseling, Pllc

LBN: Moving Mosaic Therapy & Counseling, Pllc
Moving Mosaic Therapy & Counseling, Pllc is an health care organization with primary practice located at 2232 S 18Th Ave , North Riverside IL 60546-1014. The organization recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Dance Therapist. Behavioral Health & Social Service Providers / Professional is the primary health care specialty. Moving Mosaic Therapy & Counseling, Pllc can be contacted via phone (773) 373-9682, or through Dominguez, Katie Marie via phone (773) 373-9682.

Contact Information

Primary practice address
2232 S 18Th Ave North Riverside IL 60546-1014
Phone: (773) 373-9682
Fax: (773) 312-4876
Website:
Map and Directions
Authorized official contact:
Name: Dominguez, Katie Marie MA, LCPC
Phone: (773) 373-9682

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Professional 101YP2500X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Dance Therapist 225600000X

Profile Details

NPI number 1093474652
LBN Legal business name Moving Mosaic Therapy & Counseling, Pllc
DBA Doing business as
Authorized official Dominguez, Katie Marie MA, LCPC
Entity Organization
Organization subpart 1 No
Enumeration date Dec 10th, 2021
Last updated Oct 2nd, 2023 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093474652 NPPES
Illinois Other 6839423 AETNA PPO OUTPATIENT PROVIDER
Illinois Other 1407515919 AETNA PPO OUTPATIENT PROVIDER
Illinois Other 1447804869 AETNA PPO OUTPATIENT PROVIDER
Illinois Other 1518427731 AETNA PPO OUTPATIENT PROVIDER

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