| Jeanine Standard Metamorphosis Inc | |
|
8 S Main St Suite 205 Canton IL 61520-2677 | |
| (309) 740-2171 | |
| (309) 740-2171 |
| Full Name | Jeanine Standard Metamorphosis Inc |
|---|---|
| Speciality | Psychologist |
| Location | 8 S Main St, Canton, Illinois |
| Authorized Official Name and Position | Jeanine Rene Standard (LICENSED CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 3097402171 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeanine Standard Metamorphosis Inc 8 S Main St Suite 205 Canton IL 61520-2677 Ph: (309) 740-2171 | Jeanine Standard Metamorphosis Inc 8 S Main St Suite 205 Canton IL 61520-2677 Ph: (309) 740-2171 |
| NPI Number | 1427401504 |
|---|---|
| Provider Enumeration Date | 07/13/2016 |
| Last Update Date | 07/13/2016 |
| Medicare PECOS PAC ID | 5193018919 |
|---|---|
| Medicare Enrollment ID | O20160801000772 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427401504 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 071.007101 (Illinois) | Primary |
| Provider Name | Jeanine R Standard |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790888311 PECOS PAC ID: 4587660394 Enrollment ID: I20061018000059 |
Watson Center For Wellness Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 103 S Main St, Canton, IL 61520 Phone: 309-649-6813 | |
Lutheran Social Services Of Il Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 700 E Oak St, Suite 203, Canton, IL 61520 Phone: 309-647-3325 Fax: 309-647-0262 | |
North Central Behavioral Health Systems, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 229 Martin Ave, Canton, IL 61520 Phone: 815-223-0160 Fax: 815-223-1634 | |
Braintique Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8 S Main St Ste 201, Canton, IL 61520 Phone: 309-648-9216 | |
North Central Behavioral Health Systems, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 229 Martin Ave, Canton, IL 61520 Phone: 815-223-0160 Fax: 815-223-1634 | |
Tazwood Center For Wellness Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 210 W. Walnut Street, Canton, IL 61520 Phone: 309-647-5240 |