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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: August 09, 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.

NPPES Registry Identity

NPI1053018242
Entity TypeOrganization
Primary Taxonomy261QM0801X
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.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
710 PEORIA ST, Peru, IL 61354
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D2268126

Mairti Path To Wellness · Peru, IL
Active · expires Sep 6, 2026
CLIA Number14D2268126
Laboratory TypeSubstance Use/ Mh Trmt
Certificate Effective DateSeptember 7, 2024
Certificate Expiration DateSeptember 6, 2026
Laboratory DirectorLisa K. Jones
Laboratory Phone(815) 780-0690
Laboratory LocationMairti Path To Wellness710 Peoria St, Peru, IL 61354
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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
VICTORIA MERRITT WINTERROSE
Social Worker (Clinical)
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
MS. PATRICIA ALINA PELAEZ CADC
Counselor (Addiction (Substance Use Disorder))
710 PEORIA ST
PERU, IL 61354
Lasalle County (815) 780-0690

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Maitri Path To Wellness PLLC's NPI number?

The NPI number for Maitri Path To Wellness PLLC is 1053018242. It was assigned to this organization in the NPPES registry on February 8, 2023.

Where is Maitri Path To Wellness PLLC located?

Maitri Path To Wellness PLLC is located at 710 Peoria St, Peru, IL 61354. The listed phone number is (815) 780-0690.

What is Maitri Path To Wellness PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

Does Maitri Path To Wellness PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2268126) is associated with this NPI, valid through September 6, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Maitri Path To Wellness PLLC was last updated on April 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.