1114724721 NPI number — FOR THE LOVE OF YOU COUNSELING LLC

Table of content: ISIS DALIA PALOMINO RIVERA (NPI 1417728304)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114724721 NPI number — FOR THE LOVE OF YOU COUNSELING LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FOR THE LOVE OF YOU COUNSELING LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114724721
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/01/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
18833 KEELER AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COUNTRY CLUB HILLS
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60478-5660
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
872-888-2395
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18833 KEELER AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COUNTRY CLUB HILLS
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60478-5660
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
872-888-2395
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/01/2025

Additional Information

Authorized Official

Authorized Official Last Name:
MCINTYRE
Authorized Official First Name:
TAKAHYA
Authorized Official Middle Name:
Authorized Official Title or Position:
SOCIAL WORKER
Authorized Official Telephone Number:
872-888-2395

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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