Provider Demographics
NPI:1144034406
Name:PRAIRIE VIEW COUNSELING, PLLC
Entity type:Organization
Organization Name:PRAIRIE VIEW COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LCSW
Authorized Official - Prefix:
Authorized Official - First Name:TANIA
Authorized Official - Middle Name:
Authorized Official - Last Name:YACKLE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:630-474-1257
Mailing Address - Street 1:900 OGDEN AVE STE 144
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-2829
Mailing Address - Country:US
Mailing Address - Phone:640-474-1257
Mailing Address - Fax:
Practice Address - Street 1:4520 DRENDEL ROAD
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-2421
Practice Address - Country:US
Practice Address - Phone:640-474-1257
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty