National Provider Identifier Database

MOVING MOSAIC THERAPY COUNSELING PLLC
Professional


Contact Information

MOVING MOSAIC THERAPY & COUNSELING, PLLC
2232 S 18TH AVE
NORTH RIVERSIDE, IL60546-1014
Phone: 773-373-9682
Fax: 773-312-4876
Website:
Specialty Taxonomy Code
* Professional 101YP2500X
Counselor 101Y00000X
Dance Therapist 225600000X
Mental Health 101YM0800X

* Indicates primary specialty

NPI Profile & details for MOVING MOSAIC THERAPY & COUNSELING, PLLC

NPI Number 1093474652
Legal business name
LBN
MOVING MOSAIC THERAPY & COUNSELING, PLLC
Authorized official KATIE DOMINGUEZ - (CO-FOUNDER/PSYCHOTHERAPIST)
Entity Organization
Organization subpart No
Enumeration date 12/10/2021
Last updated 10/02/2023 - About 3 years ago
Sole proprietor1 Not specified
Identifiers
  • IL Other: 6839423 AETNA PPO OUTPATIENT PROVIDER
  • IL Other: 1407515919 NPI
  • IL Other: 1518427731 NPI
  • IL Other: 1447804869 NPPES

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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