| Great Changes Counseling Services, P.c. | |
|
9435 Bormet Dr Ste 5 Mokena IL 60448-7401 | |
| (815) 260-2566 | |
| Not Available |
| Full Name | Great Changes Counseling Services, P.c. |
|---|---|
| Speciality | Social Worker |
| Location | 9435 Bormet Dr Ste 5, Mokena, Illinois |
| Authorized Official Name and Position | Donna M Welter (DIRECTOR) |
| Authorized Official Contact | 8152602566 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Changes Counseling Services, P.c. 9435 Bormet Dr Ste 5 Mokena IL 60448-7401 Ph: (815) 260-2566 | Great Changes Counseling Services, P.c. 9435 Bormet Dr Ste 5 Mokena IL 60448-7401 Ph: (815) 260-2566 |
| NPI Number | 1205137346 |
|---|---|
| Provider Enumeration Date | 11/05/2010 |
| Last Update Date | 02/06/2011 |
| Medicare PECOS PAC ID | 3375718604 |
|---|---|
| Medicare Enrollment ID | O20111214000693 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205137346 | NPI | - | NPPES |
| 1114030251 | Other | IL | NPI INDIVIDUAL # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149010490 (Illinois) | Primary |
| Provider Name | Donna M Welter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114030251 PECOS PAC ID: 1850398512 Enrollment ID: I20061023000425 |
| Provider Name | Duncan W Hall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982965539 PECOS PAC ID: 0648428789 Enrollment ID: I20120917000026 |
| Provider Name | Haley J Grasso |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902359110 PECOS PAC ID: 3274820907 Enrollment ID: I20160923001869 |
| Provider Name | Kelly Derr |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912468927 PECOS PAC ID: 7810221348 Enrollment ID: I20190702003267 |
| Provider Name | Reginald Washington Edwards |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174124036 PECOS PAC ID: 1153735824 Enrollment ID: I20210121000906 |
| Provider Name | Stephanie Ann Nash |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043984933 PECOS PAC ID: 4284025347 Enrollment ID: I20211228000055 |
| Provider Name | Deanna R Blyth |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295370930 PECOS PAC ID: 9931542065 Enrollment ID: I20240206002326 |
| Provider Name | Deanna L Stacy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558784942 PECOS PAC ID: 8224471776 Enrollment ID: I20240212002720 |
| Provider Name | Kara Marie Martino |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669584108 PECOS PAC ID: 4880031509 Enrollment ID: I20240318001372 |
| Provider Name | Judith Ann Stengele |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376885210 PECOS PAC ID: 1153768700 Enrollment ID: I20240319002580 |
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