| Authentic Living Therapeutic Services Inc | |
|
201 W Hiawatha Trail Mt. Prospect IL 60056-3763 | |
| (224) 567-3468 | |
| Not Available |
| Full Name | Authentic Living Therapeutic Services Inc |
|---|---|
| Speciality | Counselor |
| Location | 201 W Hiawatha Trail, Mt. Prospect, Illinois |
| Authorized Official Name and Position | Joyce Ann Gut (LCPC, OWNER) |
| Authorized Official Contact | 2245673468 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Authentic Living Therapeutic Services Inc 201 W Hiawatha Trail Mt. Prospect IL 60056-3763 Ph: (224) 567-3468 | Authentic Living Therapeutic Services Inc 201 W Hiawatha Trail Mt. Prospect IL 60056-3763 Ph: (224) 567-3468 |
| NPI Number | 1093580482 |
|---|---|
| Provider Enumeration Date | 11/16/2023 |
| Last Update Date | 04/30/2024 |
| Certification Date | 04/30/2024 |
| Medicare PECOS PAC ID | 7214470434 |
|---|---|
| Medicare Enrollment ID | O20240617001357 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093580482 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Joyce Gut |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366062655 PECOS PAC ID: 9537602768 Enrollment ID: I20240617001895 |
Luminate Therapy Group Of Illinois, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 580 Slawin Court, Mt. Prospect, IL 60056 Phone: 224-612-8338 Fax: 512-894-9901 |