Blue Moon Senior Counseling Of California Llc - Medicare Mental Health Clinic in Plainfield, IL

Blue Moon Senior Counseling Of California Llc is a medicare enrolled mental health clinic (Social Worker - Clinical) in Plainfield, Illinois. The current practice location for Blue Moon Senior Counseling Of California Llc is 10204 Bode St Ste B, Plainfield, Illinois. For appointments, you can reach them via phone at (855) 241-7160. The mailing address for Blue Moon Senior Counseling Of California Llc is 10204 Bode St Ste B, Plainfield, Illinois and phone number is (855) 241-7160.

Blue Moon Senior Counseling Of California Llc is licensed to practice in Florida (license number SW8327). The clinic also participates in the medicare program and its NPI number is 1447678990. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (855) 241-7160.

Contact Information

Blue Moon Senior Counseling Of California Llc
10204 Bode St Ste B
Plainfield
IL 60585-9813
(855) 241-7160
(954) 324-8354

Map and Direction


Mental Health Clinic Profile

Full NameBlue Moon Senior Counseling Of California Llc
SpecialitySocial Worker
Location10204 Bode St Ste B, Plainfield, Illinois
Authorized Official Name and PositionMelanie E Donohue (OWNER)
Authorized Official Contact8552417160
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Blue Moon Senior Counseling Of California Llc
10204 Bode St Ste B
Plainfield
IL 60585-9813

Ph: (855) 241-7160
Blue Moon Senior Counseling Of California Llc
10204 Bode St Ste B
Plainfield
IL 60585-9813

Ph: (855) 241-7160

NPI Details:

NPI Number1447678990
Provider Enumeration Date04/02/2014
Last Update Date09/20/2019

Medicare PECOS Information:

Medicare PECOS PAC ID9335360981
Medicare Enrollment IDO20141023000497

Medical Identifiers

Medical identifiers for Blue Moon Senior Counseling Of California Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1447678990NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1041C0700XSocial Worker - Clinical SW8327 (Florida)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Blue Moon Senior Counseling Of California Llc acts as a billing entity for following providers:
Provider NameBruce Rays
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1053598300
PECOS PAC ID: 3476501750
Enrollment ID: I20050104000772
Provider NameEdmund Young
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1497836670
PECOS PAC ID: 2769492917
Enrollment ID: I20060502000693
Provider NameBonnie W Meyerson
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1538297338
PECOS PAC ID: 2567526809
Enrollment ID: I20090130000438
Provider NameLillian Machin
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1902090533
PECOS PAC ID: 7416014147
Enrollment ID: I20090325000437
Provider NameCorinne Swaner
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1922284769
PECOS PAC ID: 3779776331
Enrollment ID: I20101015000374
Provider NameEleanore M Baidoo
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1255459939
PECOS PAC ID: 4486811387
Enrollment ID: I20120203000697
Provider NameCarmit Zur
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1013283753
PECOS PAC ID: 0749443745
Enrollment ID: I20120530000684
Provider NameKim C Bierwolf
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1881728574
PECOS PAC ID: 2769647304
Enrollment ID: I20120703000552
Provider NameHilda Balakhane
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1548579402
PECOS PAC ID: 8729200803
Enrollment ID: I20141104002578
Provider NameEdward Lei
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1538536230
PECOS PAC ID: 1052628286
Enrollment ID: I20150921000316
Provider NameKiana Kalaghichian
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1023381761
PECOS PAC ID: 3375848377
Enrollment ID: I20160301000791
Provider NameElizabeth Allen
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1588962617
PECOS PAC ID: 4789981747
Enrollment ID: I20160318001317
Provider NameJennifer Nicole Rugala Persicone
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1205104551
PECOS PAC ID: 3779861299
Enrollment ID: I20161103000130
Provider NameJulia Spruell Jeffery
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1275605529
PECOS PAC ID: 6002919560
Enrollment ID: I20161130000575
Provider NameKathryn A Jacobs
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1063963072
PECOS PAC ID: 6305126061
Enrollment ID: I20161215000469
Provider NamePatricia Beth Young
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1720231392
PECOS PAC ID: 1456631118
Enrollment ID: I20161215000609
Provider NameSharon J Lucas
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1679833230
PECOS PAC ID: 0547546475
Enrollment ID: I20170407001388
Provider NameDana A Walker
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1518038785
PECOS PAC ID: 1052698396
Enrollment ID: I20170515001734
Provider NameSonja Zonee Carter
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1255476362
PECOS PAC ID: 4981976255
Enrollment ID: I20170821003477
Provider NameCheryl Osman
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1427378231
PECOS PAC ID: 4082975933
Enrollment ID: I20180309001891
Provider NamePaul Goshgarian
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1861521205
PECOS PAC ID: 9931454139
Enrollment ID: I20180612000622
Provider NameJenica Polakow
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1225529159
PECOS PAC ID: 0143577502
Enrollment ID: I20180717002979
Provider NameAnqoinette Crowder-jones
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1922370311
PECOS PAC ID: 6103170980
Enrollment ID: I20181114000683
Provider NameMaurice J Williams
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1205142262
PECOS PAC ID: 4789938234
Enrollment ID: I20181119003252
Provider NameCynthia Lowe
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1639658636
PECOS PAC ID: 5890039580
Enrollment ID: I20181206002712
Provider NameCindy Hyatt
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1821042490
PECOS PAC ID: 5294746640
Enrollment ID: I20190204002513
Provider NameHila Raen
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1124251723
PECOS PAC ID: 1254679160
Enrollment ID: I20190218002616
Provider NamePatricia De La Torre
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1306966122
PECOS PAC ID: 1850631854
Enrollment ID: I20190328001079
Provider NameJulio Garibay
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1073921300
PECOS PAC ID: 2264767110
Enrollment ID: I20190715001338
Provider NameCorey Nash
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1891087128
PECOS PAC ID: 5890021018
Enrollment ID: I20190725003117
Provider NameJoanne Levine
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1285106252
PECOS PAC ID: 6103154794
Enrollment ID: I20190820003889
Provider NameJamie Trachtenberg
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1528198231
PECOS PAC ID: 1355671041
Enrollment ID: I20190923002732
Provider NameCharity Lazzari
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1801045349
PECOS PAC ID: 7113359225
Enrollment ID: I20191111002736
Provider NameYvette Wade
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1740577881
PECOS PAC ID: 2163855370
Enrollment ID: I20191202001773
Provider NameYajaira Kennison
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1700031648
PECOS PAC ID: 8820421316
Enrollment ID: I20191216000744
Provider NameTiffanie Johnson
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1083015572
PECOS PAC ID: 6709211048
Enrollment ID: I20200115001676
Provider NameVeronica Baron-vartian
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1457683633
PECOS PAC ID: 2860827847
Enrollment ID: I20200122000326
Provider NameStacey Garfinkel
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1932739356
PECOS PAC ID: 3274960489
Enrollment ID: I20200228001307
Provider NameNancy Coxwell
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1477892719
PECOS PAC ID: 0749618189
Enrollment ID: I20200317002073
Provider NameHyehyun J Park
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1679097166
PECOS PAC ID: 3274957741
Enrollment ID: I20200717000588
Provider NameAndrea Nadine Santana
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1184959116
PECOS PAC ID: 2466878855
Enrollment ID: I20200817000520
Provider NameAnne Therese Chicoine
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1447366752
PECOS PAC ID: 7810317013
Enrollment ID: I20201008001670
Provider NameDarlene Jeris
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1801202221
PECOS PAC ID: 6800216326
Enrollment ID: I20201021001392
Provider NameJhoana Sarabia
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1891102349
PECOS PAC ID: 2961822333
Enrollment ID: I20201023002169
Provider NameJacqueline Sara Mollitor
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1457542441
PECOS PAC ID: 5496175721
Enrollment ID: I20201026001872
Provider NameVimmi Jaggi
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1801107602
PECOS PAC ID: 2365862612
Enrollment ID: I20201026002678
Provider NameLeah M Kramer
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1225344088
PECOS PAC ID: 0941497101
Enrollment ID: I20201102002134
Provider NameRaizel Chaya Lax
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1588006134
PECOS PAC ID: 2668884909
Enrollment ID: I20201210001812
Provider NameEdith J. Perez
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1366824708
PECOS PAC ID: 9537574215
Enrollment ID: I20210211001948
Provider NameDorene M Fanning
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1831523711
PECOS PAC ID: 0345663274
Enrollment ID: I20210312001825
Provider NameYing Moua
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1053923300
PECOS PAC ID: 9830516699
Enrollment ID: I20210330002144
Provider NameJoyce Mayne
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1396243705
PECOS PAC ID: 4486062924
Enrollment ID: I20210421001592
Provider NameElliott Alcala
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1295241438
PECOS PAC ID: 2961811922
Enrollment ID: I20210504002931
Provider NameSpring Peabody
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1699396713
PECOS PAC ID: 1850700626
Enrollment ID: I20210506002479
Provider NameMaria Salome Garde
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1326562083
PECOS PAC ID: 4486053790
Enrollment ID: I20210518002723
Provider NameRedd Edeejahnai Davis
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1629418710
PECOS PAC ID: 7416358692
Enrollment ID: I20210624003436
Provider NameKathleen Hagerty Pestrella
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1326643404
PECOS PAC ID: 8729489877
Enrollment ID: I20210625002266
Provider NameCandace R Kerwin
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1407154362
PECOS PAC ID: 3577964436
Enrollment ID: I20210629002790
Provider NameDarren Kong
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1447685078
PECOS PAC ID: 5597169441
Enrollment ID: I20210813002883
Provider NameMelissa A Swenson
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1821361205
PECOS PAC ID: 2062817976
Enrollment ID: I20210816001850
Provider NameKarin Barragato
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1538835228
PECOS PAC ID: 1153729967
Enrollment ID: I20211008001536
Provider NameNikki Barrett
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1346856697
PECOS PAC ID: 2567850027
Enrollment ID: I20211102002682
Provider NameElliana Ixta Madera
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1922432319
PECOS PAC ID: 4688063431
Enrollment ID: I20211116002393
Provider NameJoanna S Dunton
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1841758711
PECOS PAC ID: 5991194508
Enrollment ID: I20211118002922
Provider NameDarci Elise Simms
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1053740001
PECOS PAC ID: 0648697920
Enrollment ID: I20220224002245
Provider NameRosemary Lynn Nielsen
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1649755380
PECOS PAC ID: 1658765094
Enrollment ID: I20220228002165
Provider NameKamla Fennimore
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1710274519
PECOS PAC ID: 2163651019
Enrollment ID: I20220317000561
Provider NameKaterina Leyzerovich
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1174129647
PECOS PAC ID: 9638556293
Enrollment ID: I20220519002473
Provider NameRobert James Porta
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1962550327
PECOS PAC ID: 3274910625
Enrollment ID: I20220524002474
Provider NameCarol Ruth Childers
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1396993275
PECOS PAC ID: 3476748898
Enrollment ID: I20220629002779
Provider NameJennifer Ayala
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1831679893
PECOS PAC ID: 4082094305
Enrollment ID: I20220705001676
Provider NameLiset Salcedo
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1215330170
PECOS PAC ID: 0749661981
Enrollment ID: I20220719001321
Provider NameKatherine Ann Lundell
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1578201893
PECOS PAC ID: 6709269095
Enrollment ID: I20220819000261
Provider NameYvonne Mendoza
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1689962896
PECOS PAC ID: 2567845662
Enrollment ID: I20220823002576
Provider NameDeborah Lee Hunt
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1730206087
PECOS PAC ID: 5496139610
Enrollment ID: I20220907000702
Provider NameDalia Rubi Merida Cuevas
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1205260908
PECOS PAC ID: 4082099452
Enrollment ID: I20220921001734
Provider NameMary Catherine Proffitt-allison
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1780763797
PECOS PAC ID: 7719354554
Enrollment ID: I20221107003138
Provider NameSheila Zwirn
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1871939785
PECOS PAC ID: 0749658052
Enrollment ID: I20221117001210
Provider NameJennifer Nicole Ray
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1811379506
PECOS PAC ID: 5597133785
Enrollment ID: I20221118001876
Provider NameMolly Beth Schwarzmueller
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1821668526
PECOS PAC ID: 1355710310
Enrollment ID: I20221213003379
Provider NameLaura Levin
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1053859470
PECOS PAC ID: 1557730421
Enrollment ID: I20221215001982
Provider NameKimberly Alene Rudy
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1205150760
PECOS PAC ID: 3173993763
Enrollment ID: I20221222001134
Provider NameElizabeth Bloombaum
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1316178890
PECOS PAC ID: 8820460587
Enrollment ID: I20230207002447
Provider NameShahrezad Chiha
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1194260083
PECOS PAC ID: 7517366776
Enrollment ID: I20230313002231
Provider NameJodi R Klubnik
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1952776684
PECOS PAC ID: 8628447687
Enrollment ID: I20230511003463
Provider NameWendi Jessica Avila
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1982188900
PECOS PAC ID: 6608233523
Enrollment ID: I20230608001983
Provider NameSheela Mandava
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1356816185
PECOS PAC ID: 8921465840
Enrollment ID: I20230608002180
Provider NameMaureen Rosa Salinas
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1073245577
PECOS PAC ID: 8628435427
Enrollment ID: I20230609002575
Provider NameSarah Rice
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1700010634
PECOS PAC ID: 0143686311
Enrollment ID: I20230718001996
Provider NameHannah Bernard
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1699410449
PECOS PAC ID: 0345600615
Enrollment ID: I20230718002772
Provider NameAnna L Barrios
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1639160625
PECOS PAC ID: 7113172529
Enrollment ID: I20231122000341
Provider NameCynthia Talmich
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1376013227
PECOS PAC ID: 9234589532
Enrollment ID: I20231228003405
Provider NameAnya Kaufman
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1083978449
PECOS PAC ID: 9537511480
Enrollment ID: I20240117000900
Provider NameAlicia Fahr
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1720242399
PECOS PAC ID: 2264804020
Enrollment ID: I20240325001796
Provider NameDorothea Elnora Buford-levels
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1801055389
PECOS PAC ID: 4486093846
Enrollment ID: I20240417003874
Provider NameLeticia Arteaga
Provider TypePractitioner - Marriage And Family Therapist
Provider IdentifiersNPI Number: 1609346287
PECOS PAC ID: 0143662486
Enrollment ID: I20240531001573

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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.