| Calmwaters Counseling & Resource Center Inc | |
|
108 Northport Dr Alton IL 62002-5904 | |
| (618) 466-0295 | |
| (618) 551-2676 |
| Full Name | Calmwaters Counseling & Resource Center Inc |
|---|---|
| Speciality | Counselor |
| Location | 108 Northport Dr, Alton, Illinois |
| Authorized Official Name and Position | Amy Lynn Minor (PRESIDENT/OWNER) |
| Authorized Official Contact | 6185678650 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Calmwaters Counseling & Resource Center Inc Po Box 786 Godfrey IL 62035 Ph: (618) 466-0295 | Calmwaters Counseling & Resource Center Inc 108 Northport Dr Alton IL 62002-5904 Ph: (618) 466-0295 |
| NPI Number | 1134505829 |
|---|---|
| Provider Enumeration Date | 08/04/2015 |
| Last Update Date | 06/13/2024 |
| Certification Date | 06/13/2024 |
| Medicare PECOS PAC ID | 6800103466 |
|---|---|
| Medicare Enrollment ID | O20150914002590 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134505829 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Patricia Gregory |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962856310 PECOS PAC ID: 2567702392 Enrollment ID: I20190314000487 |
| Provider Name | Lori Behrens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760522965 PECOS PAC ID: 8426390782 Enrollment ID: I20190507001469 |
| Provider Name | Amy Lynn Minor |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992249742 PECOS PAC ID: 4082067814 Enrollment ID: I20240129002778 |
| Provider Name | Patricia Breshears |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215330766 PECOS PAC ID: 0547608044 Enrollment ID: I20240403001226 |
| Provider Name | Latavia Jo Nekol Harley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770244741 PECOS PAC ID: 0648618090 Enrollment ID: I20240403003677 |
| Provider Name | Patricia Ellen Horn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174698211 PECOS PAC ID: 8628417276 Enrollment ID: I20240416003124 |
| Provider Name | Dennis Paul Billman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639370653 PECOS PAC ID: 6002257870 Enrollment ID: I20240510000530 |
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