| Bodhi Counseling & Consulting Center, Pc | |
|
206 N Randolph St Ste 432 Champaign IL 61820-3978 | |
| (217) 731-4638 | |
| Not Available |
| Full Name | Bodhi Counseling & Consulting Center, Pc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 206 N Randolph St Ste 432, Champaign, Illinois |
| Authorized Official Name and Position | Melanie Sivley (OWNER) |
| Authorized Official Contact | 2177314638 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bodhi Counseling & Consulting Center, Pc 212 E Marshall St Tolono IL 61880-9549 Ph: (217) 731-4638 | Bodhi Counseling & Consulting Center, Pc 206 N Randolph St Ste 432 Champaign IL 61820-3978 Ph: (217) 731-4638 |
| NPI Number | 1013684901 |
|---|---|
| Provider Enumeration Date | 08/27/2021 |
| Last Update Date | 04/18/2023 |
| Certification Date | 04/18/2023 |
| Medicare PECOS PAC ID | 7517324106 |
|---|---|
| Medicare Enrollment ID | O20230613003023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013684901 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Melanie Sivley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629487590 PECOS PAC ID: 1153788740 Enrollment ID: I20230613003067 |
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