Intentional Wellness Pllc | |
2501 Chatham Rd # 8191 Springfield IL 62704-4188 | |
(815) 545-3778 | |
Not Available |
Full Name | Intentional Wellness Pllc |
---|---|
Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 2501 Chatham Rd # 8191, Springfield, Illinois |
Authorized Official Name and Position | Reed Allen (LCPC) |
Authorized Official Contact | 8155453778 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Intentional Wellness Pllc 2501 Chatham Rd # 8191 Springfield IL 62704-4188 Ph: () - | Intentional Wellness Pllc 2501 Chatham Rd # 8191 Springfield IL 62704-4188 Ph: (815) 545-3778 |
NPI Number | 1407629066 |
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Provider Enumeration Date | 11/03/2023 |
Last Update Date | 11/03/2023 |
Certification Date | 11/03/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1407629066 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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