NPIMap

Organization Active NPI

Pra Behavioral LLC

  • Mental Health Counselor
  • Schaumburg, IL
National Provider Identifier
1679546873
Registry record updated Sep 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
PRA BEHAVIORAL LLC
Practice address
1701 E Woodfield Rd
Suite 1000
Schaumburg, IL 60173
Phone
(847) 240-2211
Fax
(847) 240-2418
NPI assigned
Feb 8, 2006
Last updated
Sep 4, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Paula Mazliach Comm, MA LCPCNPI 1154432771
Title
Practice Administrator
Phone
(847) 240-2211

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary
Clinical Psychologist 103TC0700X
Clinical Social Worker 1041C0700X
Psychiatry Physician 2084P0800X
Child & Adolescent Psychiatry Physician 2084P0804X

Addresses

Primary practice location

1701 E Woodfield Rd
Suite 1000
Schaumburg, IL 60173

Mailing address

1701 E Woodfield Rd
Suite 1000
Schaumburg, IL 60173-5113
Phone (847) 240-2211

Other identifiers 2

IdentifierTypeStateIssuer
1633897OtherILBCBS GROUP NUMBER
512571OtherILVALUE OPTIONS GRP #

Other names 1

  • PRA Psychiatric Group Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040227000040 IL Part B Supplier - Clinic/Group Practice 3274427729 Receives reassigned benefits from 26 practitioners
Practice locations: Schaumburg, IL

National Provider Directory

National Provider Directory

Locations

333 Commerce Dr
Ste 6
Crystal Lake, IL 60014
Phone (815) 356-5050

1701 E Woodfield Rd
Schaumburg, IL 60173
Phone (224) 269-4549

3 W Hawthorn Pkwy
Ste 2
Vernon Hills, IL 60061
Phone (847) 918-8282

3 W Hawthorn Pkwy
Ste 260
Vernon Hills, IL 60061
Phone (847) 918-8282

3 W Hawthorn Pkwy
Ste 370
Vernon Hills, IL 60061
Phone (847) 918-8282

Practitioners & affiliated clinicians

Practitioners 45

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 45

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536019200000",
    "number": "1679546873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 E WOODFIELD RD",
            "address_2": "SUITE 1000",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601735113",
            "telephone_number": "847-240-2211",
            "fax_number": "847-240-2418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 E WOODFIELD RD",
            "address_2": "SUITE 1000",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "60173",
            "telephone_number": "847-240-2211",
            "fax_number": "847-240-2418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRA BEHAVIORAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-08",
        "last_updated": "2018-09-04",
        "status": "A",
        "authorized_official_last_name": "COMM",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "MAZLIACH",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "847-240-2211",
        "authorized_official_credential": "MA LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "1633897",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS GRP #",
            "identifier": "512571",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRA Psychiatric Group",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "PRA Psychiatric Group",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Schaumburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.