| Illinois Valley Counseling Services | |
|
807 Lasalle St Ottawa IL 61350-9144 | |
| (815) 993-1614 | |
| Not Available |
| Full Name | Illinois Valley Counseling Services |
|---|---|
| Speciality | Social Worker |
| Location | 807 Lasalle St, Ottawa, Illinois |
| Authorized Official Name and Position | Shawn W Slagle (OWNER) |
| Authorized Official Contact | 8159931614 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Illinois Valley Counseling Services 1220 Tower Dr Ottawa IL 61350-9144 Ph: (815) 993-1614 | Illinois Valley Counseling Services 807 Lasalle St Ottawa IL 61350-9144 Ph: (815) 993-1614 |
| NPI Number | 1134568249 |
|---|---|
| Provider Enumeration Date | 06/21/2013 |
| Last Update Date | 06/21/2013 |
| Medicare PECOS PAC ID | 0244467066 |
|---|---|
| Medicare Enrollment ID | O20131224000001 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134568249 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149013269 (Illinois) | Primary |
| Provider Name | Wendy Navarro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386795128 PECOS PAC ID: 2567565211 Enrollment ID: I20070316000418 |
| Provider Name | Shawn W Slagle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043463268 PECOS PAC ID: 0244368496 Enrollment ID: I20100507000442 |
| Provider Name | Dawn H Mccollom |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841454766 PECOS PAC ID: 6507998515 Enrollment ID: I20100709000253 |
| Provider Name | Lori Cornelius |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275906828 PECOS PAC ID: 8921318569 Enrollment ID: I20151110002410 |
| Provider Name | Rebecca J Amble |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083029169 PECOS PAC ID: 0547557266 Enrollment ID: I20160923001498 |
| Provider Name | Traci A Midnight |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528503018 PECOS PAC ID: 3375812068 Enrollment ID: I20170712002030 |
| Provider Name | Jaime L Palacios |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104390202 PECOS PAC ID: 5193065589 Enrollment ID: I20190321001552 |
| Provider Name | Mary Josie Klass |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386236271 PECOS PAC ID: 8123433232 Enrollment ID: I20210224000380 |
| Provider Name | Kara Redshaw |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154997278 PECOS PAC ID: 3779971692 Enrollment ID: I20211026003125 |
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