Suzanne Jean Bonaventura-krischke, MSW | |
250 N Main St, Crown Point, IN 46307-3252 | |
(219) 663-6353 | |
(219) 663-6155 |
Full Name | Suzanne Jean Bonaventura-krischke |
---|---|
Gender | Female |
Speciality | Counselor - Mental Health |
Location | 250 N Main St, Crown Point, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1003817032 | NPI | - | NPPES |
200514270 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 99025239A (Indiana) | Primary |
104100000X | Social Worker | 33004882A (Indiana) | Secondary |
Entity Name | Crown Counseling Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1326290164 PECOS PAC ID: 6507172533 Enrollment ID: O20150904001314 |
Mailing Address | Practice Location Address |
---|---|
Suzanne Jean Bonaventura-krischke, MSW 250 N Main St, Crown Point, IN 46307-3278 Ph: (219) 663-6353 | Suzanne Jean Bonaventura-krischke, MSW 250 N Main St, Crown Point, IN 46307-3252 Ph: (219) 663-6353 |
Kristina Nicole Fairbanks, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 1308 N Main St, Crown Point, IN 46307 Phone: 219-663-6353 | |
Jeremy Wirtz, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 1308 N Main St, Crown Point, IN 46307 Phone: 219-663-6353 | |
Jilian M Hus, LMHC, CCMHC Counselor Medicare: Medicare Enrolled Practice Location: 11506 Kentucky St, Crown Point, IN 46307 Phone: 219-440-2239 | |
Maegan Glass, MA, LMHCA, NCC Counselor Medicare: Medicare Enrolled Practice Location: 1308 N Main St, Crown Point, IN 46307 Phone: 219-301-0206 | |
Adam Michael Johnson, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 1308 N Main St, Crown Point, IN 46307 Phone: 219-663-6353 | |
Nicole Bashan Lewis, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1325 W 98th Ave, Crown Point, IN 46307 Phone: 219-789-9185 |