| Enlighten Mind Body Wellness Llc | |
|
3106 Spring Harbour Dr Rockford IL 61114-6605 | |
| (815) 988-8756 | |
| Not Available |
| Full Name | Enlighten Mind Body Wellness Llc |
|---|---|
| Speciality | Psychologist |
| Location | 3106 Spring Harbour Dr, Rockford, Illinois |
| Authorized Official Name and Position | Sherry Falsetti (OWNER/CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 8159888756 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Enlighten Mind Body Wellness Llc 3106 Spring Harbour Dr Rockford IL 61114-6605 Ph: (815) 988-8756 | Enlighten Mind Body Wellness Llc 3106 Spring Harbour Dr Rockford IL 61114-6605 Ph: (815) 988-8756 |
| NPI Number | 1114549581 |
|---|---|
| Provider Enumeration Date | 05/08/2020 |
| Last Update Date | 05/08/2020 |
| Certification Date | 05/08/2020 |
| Medicare PECOS PAC ID | 7113349937 |
|---|---|
| Medicare Enrollment ID | O20200624003052 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114549581 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Sherry A Falsetti |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346224375 PECOS PAC ID: 6305734914 Enrollment ID: I20080403000418 |
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