Maitri Path to Wellness Pllc

NPI #1184204950 in Peru, Illinois

Provider Information

NPI Number: 1184204950
Entity Type: Organization
Organization Name: Maitri Path to Wellness Pllc
Primary Specialty: Social Worker - Clinical
Enumeration Date: Apr 14, 2021
Last Updated: Apr 19, 2024

Practice Location

Address: 710 PEORIA ST
City: Peru
State: Illinois
ZIP Code: 61354-3351
Phone: (815) 780-0690

Authorized Official

Name: BRENDEN FASKEN
Title: CHIEF OPERATING OFFICER
Phone: (815) 780-0690

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Counselor - Professional — Professional	101YP2500X
Social Worker	104100000X
Social Worker - Clinical — Clinical	1041C0700X	Primary

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