| Connected Counseling | |
|
6072 Brynwood Dr Ste 107a Rockford IL 61114-5829 | |
| (815) 708-7349 | |
| Not Available |
| Full Name | Connected Counseling |
|---|---|
| Speciality | Counselor |
| Location | 6072 Brynwood Dr Ste 107a, Rockford, Illinois |
| Authorized Official Name and Position | Todd Daniel Burd (OWNER/THERAPIST) |
| Authorized Official Contact | 7799037625 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Connected Counseling 6072 Brynwood Dr Ste 107a Rockford IL 61114-5829 Ph: (779) 903-7625 | Connected Counseling 6072 Brynwood Dr Ste 107a Rockford IL 61114-5829 Ph: (815) 708-7349 |
| NPI Number | 1922631274 |
|---|---|
| Provider Enumeration Date | 02/14/2020 |
| Last Update Date | 02/14/2024 |
| Certification Date | 02/14/2024 |
| Medicare PECOS PAC ID | 7416398177 |
|---|---|
| Medicare Enrollment ID | O20240513000331 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922631274 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Todd D Burd |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770975484 PECOS PAC ID: 8325489081 Enrollment ID: I20240513000405 |
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