Logan Spicer, | |
9855 W Roosevelt Rd, Westchester, IL 60154-2758 | |
(708) 681-2325 | |
Not Available |
Full Name | Logan Spicer |
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Gender | Female |
Speciality | Counselor - Professional |
Location | 9855 W Roosevelt Rd, Westchester, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1770140949 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | NONE (* (Not Available)) | Secondary |
101YP2500X | Counselor - Professional | 180015338 (Illinois) | Primary |
Entity Name | Thriveworks Clinical - Illinois |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1164190633 PECOS PAC ID: 6800263823 Enrollment ID: O20221104000575 |
Mailing Address | Practice Location Address |
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Logan Spicer, 3123 S Shields Ave Apt Bsmt, Chicago, IL 60616-4967 Ph: (317) 619-9225 | Logan Spicer, 9855 W Roosevelt Rd, Westchester, IL 60154-2758 Ph: (708) 681-2325 |
Mrs. Lindsey Rogers, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1 Westbrook Corporate Ctr Ste 300, Westchester, IL 60154 Phone: 312-515-4644 | |
Ms. Toya Rhashinda Hodges, LCSW, LSW, CADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1 Westbrook Corporate Ctr Ste 300, Westchester, IL 60154 Phone: 708-275-7575 | |
James Isador Kowalsky, Counselor Medicare: Not Enrolled in Medicare Practice Location: 9845 W Roosevelt Rd, Westchester, IL 60154 Phone: 708-681-2325 | |
Ms. Nicole Lauren Rosene, LCSW, MSW Counselor Medicare: Accepting Medicare Assignments Practice Location: 9855 W Roosevelt Rd, Westchester, IL 60154 Phone: 708-681-2325 | |
Ms. Ranya Hasan, Counselor Medicare: Not Enrolled in Medicare Practice Location: 9845 W Roosevelt Rd, Westchester, IL 60154 Phone: 708-681-2325 | |
Marianne E Royster, B.A. Counselor Medicare: Not Enrolled in Medicare Practice Location: 9845 W Roosevelt Rd, Westchester, IL 60154 Phone: 708-681-2325 Fax: 708-681-2383 | |
Mr. John M Michet, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2434 Wolf Rd, Westchester, IL 60154 Phone: 708-562-5430 |