| Creative Wisdom Counseling Services, Llc | |
|
2700 W Ardmore Pl West Peoria IL 61604-4934 | |
| (309) 989-0052 | |
| Not Available |
| Full Name | Creative Wisdom Counseling Services, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2700 W Ardmore Pl, West Peoria, Illinois |
| Authorized Official Name and Position | Karen L Watson (MENTAL HEALTH PROFESSIONAL) |
| Authorized Official Contact | 3099890052 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Creative Wisdom Counseling Services, Llc 2700 W Ardmore Pl West Peoria IL 61604-4934 Ph: (309) 989-0052 | Creative Wisdom Counseling Services, Llc 2700 W Ardmore Pl West Peoria IL 61604-4934 Ph: (309) 989-0052 |
| NPI Number | 1851995641 |
|---|---|
| Provider Enumeration Date | 11/23/2020 |
| Last Update Date | 09/19/2024 |
| Certification Date | 09/19/2024 |
| Medicare PECOS PAC ID | 1658783493 |
|---|---|
| Medicare Enrollment ID | O20201218001750 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851995641 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Karen Lynn Watson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104009224 PECOS PAC ID: 4880850262 Enrollment ID: I20120731000063 |
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