| Eric Jon Tanner, LCPC | |
|
11361 Main St, Roscoe, IL 61073-8851 | |
| (779) 212-4721 | |
| Not Available |
| Full Name | Eric Jon Tanner |
|---|---|
| Gender | Male |
| Speciality | Counselor - Professional |
| Location | 11361 Main St, Roscoe, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689269003 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 180.13458 (Illinois) | Primary |
| Entity Name | Grow Healthcare Group Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20220414000139 |
| Entity Name | Imagine More Counseling Solutions Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598346561 PECOS PAC ID: 3072048131 Enrollment ID: O20241126001877 |
| Mailing Address | Practice Location Address |
|---|---|
| Eric Jon Tanner, LCPC 7431 E State St Ste 354, Rockford, IL 61108-2678 Ph: (779) 212-4721 | Eric Jon Tanner, LCPC 11361 Main St, Roscoe, IL 61073-8851 Ph: (779) 212-4721 |
Joseph T Marella, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 11447 2nd St Ste 9b, Roscoe, IL 61073 Phone: 815-601-4673 Fax: 866-303-8062 | |
Jamie R Wagner, LCPC, LPC, RPT-S Counselor Medicare: Not Enrolled in Medicare Practice Location: 11447 2nd St, Suite 9b, Roscoe, IL 61073 Phone: 815-601-4673 Fax: 866-303-8062 | |
Mrs. Amanda Dee Musfelt, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 5290 Williams Dr, Roscoe, IL 61073 Phone: 815-324-0324 | |
Sreeka Bharani, CRC, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 11447 2nd St, Roscoe, IL 61073 Phone: 815-623-2020 | |
Regino Isidro Sta Cruz Jr., Counselor Medicare: Not Enrolled in Medicare Practice Location: 5290 Williams Dr, Roscoe, IL 61073 Phone: 815-324-0324 | |
Mrs. Allison Diane Braswell, MSW, LCSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 4675 Bluestem Rd, Roscoe, IL 61073 Phone: 815-978-1067 Fax: 779-537-4555 | |
Karen Lakis, MS, NCC, CADC, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 11447 2nd St Ste 9b, Roscoe, IL 61073 Phone: 815-601-4673 Fax: 866-303-8062 |