| Fash Counseling Inc | |
|
684 W Boughton Rd Ste 106 Bolingbrook IL 60440-1781 | |
| (630) 410-9578 | |
| (630) 296-0749 |
| Full Name | Fash Counseling Inc |
|---|---|
| Speciality | Counselor |
| Location | 684 W Boughton Rd Ste 106, Bolingbrook, Illinois |
| Authorized Official Name and Position | Jenna Fash (OWNER) |
| Authorized Official Contact | 6304109578 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fash Counseling Inc 684 W Boughton Rd Ste 106 Bolingbrook IL 60440-1781 Ph: (630) 410-9578 | Fash Counseling Inc 684 W Boughton Rd Ste 106 Bolingbrook IL 60440-1781 Ph: (630) 410-9578 |
| NPI Number | 1346766250 |
|---|---|
| Provider Enumeration Date | 08/22/2017 |
| Last Update Date | 07/21/2022 |
| Certification Date | 09/09/2020 |
| Medicare PECOS PAC ID | 4183003056 |
|---|---|
| Medicare Enrollment ID | O20220623000974 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346766250 | NPI | - | NPPES |
| 1508401209 | Other | IL | SOCIAL WORK |
| 1104488980 | Other | IL | CLINICAL PSYCHOLOGY |
| 1255666707 | Other | IL | BEHAVIORAL HEALTH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | 180008047 (Illinois) | Secondary |
| Provider Name | Tracy Lynn Cunningham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508401209 PECOS PAC ID: 4183095771 Enrollment ID: I20230118001153 |
| Provider Name | Jenna Lynn Fash |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255666707 PECOS PAC ID: 9133534415 Enrollment ID: I20240201003059 |
| Provider Name | Emilie Brazinski |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841807765 PECOS PAC ID: 9133562903 Enrollment ID: I20240208002050 |
| Provider Name | Ashley White |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174934376 PECOS PAC ID: 0244674539 Enrollment ID: I20240214002484 |
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