| Dynamic Counseling And Consultation Services | |
|
4202 Williamson Pl Ste 1 Mount Vernon IL 62864-6760 | |
| (618) 816-1224 | |
| (800) 335-4761 |
| Full Name | Dynamic Counseling And Consultation Services |
|---|---|
| Speciality | Social Worker |
| Location | 4202 Williamson Pl Ste 1, Mount Vernon, Illinois |
| Authorized Official Name and Position | Carrie Crocker (OWNER) |
| Authorized Official Contact | 6188161224 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dynamic Counseling And Consultation Services 1111 S Lincoln Ave Unit 1326 O Fallon IL 62269-5165 Ph: (618) 816-1224 | Dynamic Counseling And Consultation Services 4202 Williamson Pl Ste 1 Mount Vernon IL 62864-6760 Ph: (618) 816-1224 |
| NPI Number | 1457771677 |
|---|---|
| Provider Enumeration Date | 04/27/2014 |
| Last Update Date | 01/27/2025 |
| Certification Date | 01/27/2025 |
| Medicare PECOS PAC ID | 6709186703 |
|---|---|
| Medicare Enrollment ID | O20151124000258 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457771677 | NPI | - | NPPES |
| 497312108 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 2003032196 (Missouri) | Primary |
| Provider Name | Carrie C Crocker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972657187 PECOS PAC ID: 6002947017 Enrollment ID: I20151124000336 |
| Provider Name | Tiffany Nicole Shurtz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467112417 PECOS PAC ID: 6002200888 Enrollment ID: I20220221000700 |
Sleep & Neurology Center Of Southern Illinois, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2 Good Samaritan Way, Suite 400, Mount Vernon, IL 62864 Phone: 618-241-1869 | |
Choices Counseling, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1315 Main St, Mount Vernon, IL 62864 Phone: 618-505-2784 Fax: 618-505-1875 | |
One Hope United Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2929 Broadway St, Suite 7a, Mount Vernon, IL 62864 Phone: 618-242-8226 | |
Roots Of Hope Counseling Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3600 S Water Tower Pl, Mount Vernon, IL 62864 Phone: 618-244-0212 | |
Living Hope Counseling Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3600 S Water Tower Pl, Mount Vernon, IL 62864 Phone: 706-483-6926 |