Provider Demographics
NPI:1720897119
Name:AMY MOUNTSIER, LLC
Entity type:Organization
Organization Name:AMY MOUNTSIER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:MOUNTSIER
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:815-790-9452
Mailing Address - Street 1:103 WEST DRIVE
Mailing Address - Street 2:
Mailing Address - City:TOWER LAKES
Mailing Address - State:IL
Mailing Address - Zip Code:60010
Mailing Address - Country:US
Mailing Address - Phone:815-790-9452
Mailing Address - Fax:
Practice Address - Street 1:103 WEST DRIVE
Practice Address - Street 2:
Practice Address - City:TOWER LAKES
Practice Address - State:IL
Practice Address - Zip Code:60010
Practice Address - Country:US
Practice Address - Phone:815-790-9452
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-31
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty