| Behavioral Health Center Of Illinois | |
|
1220 S 7th St Springfield IL 62703-2421 | |
| (217) 679-5379 | |
| (217) 679-5349 |
| Full Name | Behavioral Health Center Of Illinois |
|---|---|
| Speciality | Clinic/Center |
| Location | 1220 S 7th St, Springfield, Illinois |
| Authorized Official Name and Position | Sara Bahn (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 2176795379 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Behavioral Health Center Of Illinois 1220 S 7th St Springfield IL 62703-2421 Ph: (217) 679-5379 | Behavioral Health Center Of Illinois 1220 S 7th St Springfield IL 62703-2421 Ph: (217) 679-5379 |
| NPI Number | 1932408929 |
|---|---|
| Provider Enumeration Date | 03/16/2011 |
| Last Update Date | 03/18/2021 |
| Certification Date | 03/18/2021 |
| Medicare PECOS PAC ID | 2860630530 |
|---|---|
| Medicare Enrollment ID | O20130607000684 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932408929 | NPI | - | NPPES |
| Provider Name | Sara J Bahn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407163108 PECOS PAC ID: 1153447479 Enrollment ID: I20130618000843 |
| Provider Name | Sophie Rose Roth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003212564 PECOS PAC ID: 6305164443 Enrollment ID: I20150421001722 |
| Provider Name | Melanie A Jesse |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922551316 PECOS PAC ID: 2668759812 Enrollment ID: I20170426000902 |
| Provider Name | Jesse Gutierrez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891282760 PECOS PAC ID: 4880949197 Enrollment ID: I20180608001477 |
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