Genesis Counseling Llc | |
208 S 1st Ave Morton IL 61550-2037 | |
(309) 258-5713 | |
Not Available |
Full Name | Genesis Counseling Llc |
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Speciality | Clinic/Center |
Location | 208 S 1st Ave, Morton, Illinois |
Authorized Official Name and Position | Emma Kathryn Bucher (CLINICAL PSYCHOLOGIST) |
Authorized Official Contact | 3092585713 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Genesis Counseling Llc 309 W Birchwood St Morton IL 61550-2405 Ph: (309) 258-5713 | Genesis Counseling Llc 208 S 1st Ave Morton IL 61550-2037 Ph: (309) 258-5713 |
NPI Number | 1477184356 |
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Provider Enumeration Date | 01/30/2020 |
Last Update Date | 01/30/2020 |
Certification Date | 01/30/2020 |
Medicare PECOS PAC ID | 5193154342 |
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Medicare Enrollment ID | O20201002001765 |
Identifier | Type | State | Issuer |
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1477184356 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Provider Name | Emma K Bucher |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1619523479 PECOS PAC ID: 1850623802 Enrollment ID: I20191024002262 |
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