| Helen Woodrum Lcsw Pllc | |
|
114 E Everett St Ste 208 Dixon IL 61021-2140 | |
| (815) 994-6400 | |
| Not Available |
| Full Name | Helen Woodrum Lcsw Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 114 E Everett St Ste 208, Dixon, Illinois |
| Authorized Official Name and Position | Helen R Woodrum (OWNER, THERAPIST) |
| Authorized Official Contact | 8152771049 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Helen Woodrum Lcsw Pllc 114 E Everett St Ste 208 Dixon IL 61021-2140 Ph: (815) 994-6400 | Helen Woodrum Lcsw Pllc 114 E Everett St Ste 208 Dixon IL 61021-2140 Ph: (815) 994-6400 |
| NPI Number | 1740958297 |
|---|---|
| Provider Enumeration Date | 08/31/2021 |
| Last Update Date | 08/31/2021 |
| Certification Date | 08/31/2021 |
| Medicare PECOS PAC ID | 2567852312 |
|---|---|
| Medicare Enrollment ID | O20211209001275 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740958297 | NPI | - | NPPES |
| 149015750 | Other | IL | IL DEPT. FINANCIAL AND PROF. REGULATION |
| 149015750 | Other | IL | ILLINOIS DEPARTMENT OF PROFESSIONAL REGULATION- LCSW |
| 12588016 | Other | IL | CAQH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Helen R Woodrum |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881986636 PECOS PAC ID: 6406090240 Enrollment ID: I20130918000451 |
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