| Inner Equinox Counseling Center Llc | |
|
8600 Us Highway 14 Ste 220a Crystal Lake IL 60012-2711 | |
| (224) 338-6038 | |
| Not Available |
| Full Name | Inner Equinox Counseling Center Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8600 Us Highway 14 Ste 220a, Crystal Lake, Illinois |
| Authorized Official Name and Position | Michelle Ann Krc Gerlach (CLINICAL THERAPIST) |
| Authorized Official Contact | 2243386038 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Inner Equinox Counseling Center Llc 215 Fenimore Rd Crystal Lake IL 60014-7377 Ph: (224) 338-6038 | Inner Equinox Counseling Center Llc 8600 Us Highway 14 Ste 220a Crystal Lake IL 60012-2711 Ph: (224) 338-6038 |
| NPI Number | 1811579030 |
|---|---|
| Provider Enumeration Date | 04/27/2021 |
| Last Update Date | 12/13/2024 |
| Certification Date | 12/13/2024 |
| Medicare PECOS PAC ID | 1759767916 |
|---|---|
| Medicare Enrollment ID | O20220926003323 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811579030 | NPI | - | NPPES |
| F400646798 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Michelle Ann Krc |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730647090 PECOS PAC ID: 8628307634 Enrollment ID: I20190916003063 |
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