Kaleidoscope Clinical Counseling, Pllc | |
330 Division Dr Ste J Sugar Grove IL 60554-9800 | |
(630) 708-0317 | |
Not Available |
Full Name | Kaleidoscope Clinical Counseling, Pllc |
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Speciality | Counselor |
Location | 330 Division Dr Ste J, Sugar Grove, Illinois |
Authorized Official Name and Position | Amy Heiman (OWNER/COUNSELOR) |
Authorized Official Contact | 6307080317 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Kaleidoscope Clinical Counseling, Pllc 330 Division Dr Ste J Sugar Grove IL 60554-9800 Ph: (630) 708-0317 | Kaleidoscope Clinical Counseling, Pllc 330 Division Dr Ste J Sugar Grove IL 60554-9800 Ph: (630) 708-0317 |
NPI Number | 1669223780 |
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Provider Enumeration Date | 03/27/2024 |
Last Update Date | 03/27/2024 |
Certification Date | 03/27/2024 |
Medicare PECOS PAC ID | 9335681196 |
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Medicare Enrollment ID | O20240607001285 |
Identifier | Type | State | Issuer |
---|---|---|---|
1669223780 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
Provider Name | Amy Jo Heiman |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1912907932 PECOS PAC ID: 4082057625 Enrollment ID: I20240209003351 |
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