| Enlightening Journey Clinical Therapy Services, Inc. | |
|
7443 Washington St Forest Park IL 60130-1549 | |
| (331) 244-0956 | |
| Not Available |
| Full Name | Enlightening Journey Clinical Therapy Services, Inc. |
|---|---|
| Speciality | Counselor |
| Location | 7443 Washington St, Forest Park, Illinois |
| Authorized Official Name and Position | Maria Cruz (OWNER) |
| Authorized Official Contact | 3312440956 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Enlightening Journey Clinical Therapy Services, Inc. 7443 Washington St 301 Forest Park IL 60130 Ph: () - | Enlightening Journey Clinical Therapy Services, Inc. 7443 Washington St Forest Park IL 60130-1549 Ph: (331) 244-0956 |
| NPI Number | 1245974716 |
|---|---|
| Provider Enumeration Date | 04/21/2022 |
| Last Update Date | 01/16/2025 |
| Certification Date | 01/16/2025 |
| Medicare PECOS PAC ID | 8123569852 |
|---|---|
| Medicare Enrollment ID | O20240923000787 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245974716 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| Provider Name | Maria Cruz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245694009 PECOS PAC ID: 6901298140 Enrollment ID: I20240923000841 |
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