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MAITRI PATH TO WELLNESS PLLC
NPI 1053018242
Clinic/Center - Mental Health (Including Community Mental Health Center) in Peru, IL

Active since February 08, 2023CLIA 14D2268126 · Waiver
710 PEORIA ST, PERU, IL 61354(815) 780-0690(815) 410-1937 Get Directions Write a Review

NPPES record last updated: April 17, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Apr 17, 2024, Feb 8, 2023 (2 updates tracked since 2023).

About Maitri Path To Wellness Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MAITRI PATH TO WELLNESS PLLC (NPI 1053018242) is a healthcare organization registered as a mental health (including community mental health center) in Peru, Illinois and active in the NPI registry since February 2023. The organization holds a CLIA Waiver certificate valid through September 6, 2026 and lists Brenden Fasken, Chief Operating Officer, as its authorized official.Information from the official NPPES registry record, last updated April 17, 2024.

NPPES Registry Identity

NPI1053018242
Entity TypeOrganization
Legal Business NameMAITRI PATH TO WELLNESS PLLC
Location Address710 PEORIA STPeru, IL 61354-3351
Mailing Address710 Peoria StPeru, IL 61354-3351 · (815) 780-0690 · Fax (815) 410-1937
Phone(815) 780-0690
Fax(815) 410-1937
Organization SubpartNo
Authorized OfficialBrenden FaskenChief Operating Officer · (815) 780-0690
Enumeration DateFebruary 8, 2023
Last NPPES UpdateApril 17, 20242 updates tracked since enumeration
NPPES CertifiedApril 17, 2024
✔ NPI 1053018242 is a valid, active identifier and passes the ISO check-digit test. How NPI validation works

★ Primary Specialty

Clinic/Center · Mental Health (Including Community Mental Health Center)

Taxonomy 261QM0801X · Ambulatory Health Care Facilities

710 PEORIA ST, Peru, IL 61354
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CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
14D2268126
Facility Type
Other - SUBSTANCE USE/ MH TRMT
Certificate Effective Date
September 07, 2024
Certificate Expiration Date
September 06, 2026
Laboratory Director
LISA K. JONES
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Maitri Path To Wellness Pllc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for MAITRI PATH TO WELLNESS PLLC

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Other Providers at the Same Location


The following 14 providers are registered at the same or a nearby location.

SHANNA O'BRIEN LSW
Social Worker
710 PEORIA ST
PERU, IL 61354
Lasalle County (815) 780-0690
VANESSA ABELLAN CADC
Counselor (Addiction (Substance Use Disorder))
710 PEORIA ST
PERU, IL 61354
Lasalle County (815) 780-0690
BRENDEN FASKEN
Counselor (Addiction (Substance Use Disorder))
710 PEORIA ST
PERU, IL 61354
Lasalle County (815) 780-0690
KAYLA MARIE FALLEN
Counselor (Mental Health)
710 PEORIA ST
PERU, IL 61354
Lasalle County (815) 780-0690
MAITRI PATH TO WELLNESS PLLC
Social Worker (Clinical)
710 PEORIA ST
PERU, IL 61354
Lasalle County (815) 780-0690
MAITRI PATH TO WELLNESS PLLC
Clinic/Center (Rehabilitation, Substance Use Disorder)
710 PEORIA ST
PERU, IL 61354
Lasalle County (815) 780-0690
WELLNESS AND RECOVERY WITH MAITRI, INC. NFP
Clinic/Center (Mental Health (Including Community Mental Health Center))
710 PEORIA ST
PERU, IL 61354
Lasalle County (815) 780-0690
PATRICIA MICHAELS
Counselor (Mental Health)
710 PEORIA ST
PERU, IL 61354
Lasalle County (815) 780-0690
LISA KELLY JONES
Social Worker (Clinical)
710 PEORIA ST
PERU, IL 61354
Lasalle County (815) 780-0690
VICTORIA MERRITT WINTERROSE
Social Worker (Clinical)
710 PEORIA ST
PERU, IL 61354
Lasalle County (815) 780-0690
TAMARA LEIGH BEABER LSW
Social Worker (Clinical)
710 PEORIA ST
PERU, IL 61354
Lasalle County (815) 780-0690
MS. PATRICIA ALINA PELAEZ CADC
Counselor (Addiction (Substance Use Disorder))
710 PEORIA ST
PERU, IL 61354
Lasalle County (815) 780-0690
RACHEL MARIE EDGCOMB CADC
Social Worker (Clinical)
710 PEORIA ST
PERU, IL 61354
Lasalle County (815) 780-0690
MORGAN TORMAN LSW
Social Worker
710 PEORIA ST
PERU, IL 61354
Lasalle County (815) 780-0690

Frequently Asked Questions

What is MAITRI PATH TO WELLNESS PLLC's NPI number?

The NPI number assigned to this healthcare provider is 1053018242, enumerated as an "organization" on February 08, 2023.

Where is the provider located?

The provider is located at 710 PEORIA ST PERU, IL 61354 and the phone number is (815) 780-0690.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QM0801X and a focus in Mental Health (Including Community Mental Health Center).