| Elliott Counseling Group | |
|
309 W Clark St Champaign IL 61820 | |
| (217) 398-9066 | |
| (217) 398-9077 |
| Full Name | Elliott Counseling Group |
|---|---|
| Speciality | Registered Nurse - Psychiatric/mental Health, Child & Adolescent |
| Location | 309 W Clark St, Champaign, Illinois |
| Authorized Official Name and Position | Melanie I Hoogstraat (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 2175521211 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elliott Counseling Group 44 E Main St Suite 406 Champaign IL 61820-3636 Ph: (217) 398-9066 | Elliott Counseling Group 309 W Clark St Champaign IL 61820 Ph: (217) 398-9066 |
| NPI Number | 1871877621 |
|---|---|
| Provider Enumeration Date | 09/28/2011 |
| Last Update Date | 11/04/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871877621 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149014837 (Illinois) | Secondary |
| 163WP0807X | Registered Nurse - Psychiatric/mental Health, Child & Adolescent | (* (Not Available)) | Primary |
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