Janiese Myesha Asque

Individual provider Active NPI Mental Health Counselor · South Holland, IL

NPI 1073299343 · NPPES record last updated Jun 22, 2023

Key facts

NPI
1073299343
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
16519 Ellis Ave
South Holland, IL 60473-2426
Phone
(312) 599-3436
NPI assigned
Jun 22, 2023
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

16519 Ellis Ave
South Holland, IL 60473-2426

Mailing address

16519 Ellis Ave
South Holland, IL 60473-2426
Phone (312) 599-3436

Other providers in South Holland, IL

All providers in South Holland, IL · Mental Health Counselor in Illinois

Sources for this page

Verify at the official NPI Registry.