Provider Demographics
NPI:1356134878
Name:REPURPOSED COUNSELING & COACHING, PLLC
Entity type:Organization
Organization Name:REPURPOSED COUNSELING & COACHING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:R S
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:708-528-3766
Mailing Address - Street 1:933 S MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:VILLA PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60181-3140
Mailing Address - Country:US
Mailing Address - Phone:708-528-3766
Mailing Address - Fax:
Practice Address - Street 1:1550 SPRING RD STE 106
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-3603
Practice Address - Country:US
Practice Address - Phone:708-528-3766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty