Provider Demographics
NPI:1861162638
Name:MEILS, BENJAMIN KYLE (LCPC)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:KYLE
Last Name:MEILS
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 W 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:IL
Mailing Address - Zip Code:60927-9300
Mailing Address - Country:US
Mailing Address - Phone:815-922-5275
Mailing Address - Fax:
Practice Address - Street 1:755 ALMAR PKWY STE A
Practice Address - Street 2:
Practice Address - City:BOURBONNAIS
Practice Address - State:IL
Practice Address - Zip Code:60914-2393
Practice Address - Country:US
Practice Address - Phone:815-315-9901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-14
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
IL178018429101YP2500X
IL180.016902101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health