Provider Demographics
NPI:1447874771
Name:EXPERIENCE COUNSELING LLC
Entity type:Organization
Organization Name:EXPERIENCE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:AUSRA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAUGINAITE
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:312-622-6962
Mailing Address - Street 1:1530 AZTEC CIR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-1206
Mailing Address - Country:US
Mailing Address - Phone:312-622-6962
Mailing Address - Fax:
Practice Address - Street 1:100 BATSON CT STE 206
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-1565
Practice Address - Country:US
Practice Address - Phone:312-622-6962
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-02
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty