| Balanced | |
|
607 W Burton Ave Eureka IL 61530-1356 | |
| (309) 251-1900 | |
| Not Available |
| Full Name | Balanced |
|---|---|
| Speciality | Social Worker |
| Location | 607 W Burton Ave, Eureka, Illinois |
| Authorized Official Name and Position | Amy Braman (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 3092511900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Balanced 607 W Burton Ave Eureka IL 61530-1356 Ph: () - | Balanced 607 W Burton Ave Eureka IL 61530-1356 Ph: (309) 251-1900 |
| NPI Number | 1225332273 |
|---|---|
| Provider Enumeration Date | 01/05/2011 |
| Last Update Date | 01/05/2011 |
| Medicare PECOS PAC ID | 9830352020 |
|---|---|
| Medicare Enrollment ID | O20120525000595 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225332273 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149011988 (Illinois) | Primary |
| 1041C0700X | Social Worker - Clinical | 149008793 (Illinois) | Secondary |
| Provider Name | Jessica M Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831533009 PECOS PAC ID: 5294763132 Enrollment ID: I20050801001020 |
| Provider Name | Margaret A Bagley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922178409 PECOS PAC ID: 8628095189 Enrollment ID: I20051025000369 |
| Provider Name | Jennifer E Boehs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154620615 PECOS PAC ID: 5294998480 Enrollment ID: I20120531000023 |
| Provider Name | Amy E Braman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417256975 PECOS PAC ID: 6103089396 Enrollment ID: I20120531000038 |
| Provider Name | Ruth A Jennings |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568689511 PECOS PAC ID: 2365712098 Enrollment ID: I20170727003247 |
| Provider Name | Jennifer M Zeck |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154845089 PECOS PAC ID: 1456625144 Enrollment ID: I20170919002217 |
| Provider Name | Meryl J Block |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619296688 PECOS PAC ID: 0840558193 Enrollment ID: I20171214002977 |
| Provider Name | Heidi L Colton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841645066 PECOS PAC ID: 0840542635 Enrollment ID: I20181005000405 |
| Provider Name | Pamela S Gottschalk |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558798751 PECOS PAC ID: 1153739016 Enrollment ID: I20210414002593 |
| Provider Name | Stephen Dejaynes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639410772 PECOS PAC ID: 2062860604 Enrollment ID: I20240117003129 |
| Provider Name | Dee Anne Reimers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568623304 PECOS PAC ID: 4284083908 Enrollment ID: I20240118001507 |
| Provider Name | Susan Beckman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598303042 PECOS PAC ID: 1456709096 Enrollment ID: I20240119000774 |
| Provider Name | Michelle Alcorn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427642826 PECOS PAC ID: 2668820200 Enrollment ID: I20240215000348 |
| Provider Name | Kay Blankenship |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750857744 PECOS PAC ID: 6103274741 Enrollment ID: I20240401000137 |
| Provider Name | Christina Showalter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689098733 PECOS PAC ID: 5294183612 Enrollment ID: I20240411000457 |
| Provider Name | Andrea Grimes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538623582 PECOS PAC ID: 7719326834 Enrollment ID: I20240422001616 |
Tazwood Mental Health Center, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 101 S. Major Street, Eureka, IL 61530 Phone: 309-694-6462 Fax: 309-347-4264 |