| Broadreach Counseling Llc | |
|
1580 S Milwaukee Ave Ste 104 Libertyville IL 60048-3770 | |
| (847) 636-6134 | |
| Not Available |
| Full Name | Broadreach Counseling Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1580 S Milwaukee Ave Ste 104, Libertyville, Illinois |
| Authorized Official Name and Position | Katherine Henoch (CO-OWNER/PSYCHOTHERAPIST) |
| Authorized Official Contact | 8473489501 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Broadreach Counseling Llc 1580 S Milwaukee Ave Ste 104 Libertyville IL 60048-3770 Ph: (847) 348-9501 | Broadreach Counseling Llc 1580 S Milwaukee Ave Ste 104 Libertyville IL 60048-3770 Ph: (847) 636-6134 |
| NPI Number | 1063937324 |
|---|---|
| Provider Enumeration Date | 08/08/2017 |
| Last Update Date | 11/13/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063937324 | NPI | - | NPPES |
| 331742678001 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 180.010359 (Illinois) | Secondary |
| 1041C0700X | Social Worker - Clinical | 149.018710 (Illinois) | Primary |
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