| Anxiety And Stress Relief Center Pllc | |
|
110 N Main St Breese IL 62230-1630 | |
| (618) 322-6424 | |
| (618) 227-8227 |
| Full Name | Anxiety And Stress Relief Center Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 110 N Main St, Breese, Illinois |
| Authorized Official Name and Position | Christina R Diesen (OWNER/PROVIDER) |
| Authorized Official Contact | 6183226424 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anxiety And Stress Relief Center Pllc 110 N Main St Breese IL 62230-1630 Ph: (618) 322-6424 | Anxiety And Stress Relief Center Pllc 110 N Main St Breese IL 62230-1630 Ph: (618) 322-6424 |
| NPI Number | 1619686417 |
|---|---|
| Provider Enumeration Date | 11/21/2022 |
| Last Update Date | 01/11/2024 |
| Certification Date | 01/11/2024 |
| Medicare PECOS PAC ID | 7012350739 |
|---|---|
| Medicare Enrollment ID | O20240209002480 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619686417 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Christina R Diesen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326161969 PECOS PAC ID: 6406952472 Enrollment ID: I20240209002543 |
Bridgewater Counseling Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10551 Vonder Haar Ln, Breese, IL 62230 Phone: 618-520-3339 | |
Coping 4 Kids Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 900 N Walnut St., Breese, IL 62230 Phone: 618-830-5312 | |
Christina R. Diesen, Lcsw Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 N Main St, Breese, IL 62230 Phone: 618-322-6424 Fax: 618-227-8227 |