| Kim Greenlee Counseling Services, Llc | |
|
2506 Galen Dr Ste 108 Champaign IL 61821-7047 | |
| (217) 262-9508 | |
| (217) 703-8988 |
| Full Name | Kim Greenlee Counseling Services, Llc |
|---|---|
| Speciality | Counselor |
| Location | 2506 Galen Dr Ste 108, Champaign, Illinois |
| Authorized Official Name and Position | Kimberly Greenlee (OWNER/LEAD THERAPIST) |
| Authorized Official Contact | 2172629508 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kim Greenlee Counseling Services, Llc 2506 Galen Dr Ste 108 Champaign IL 61821-7047 Ph: (217) 262-9508 | Kim Greenlee Counseling Services, Llc 2506 Galen Dr Ste 108 Champaign IL 61821-7047 Ph: (217) 262-9508 |
| NPI Number | 1659962041 |
|---|---|
| Provider Enumeration Date | 01/29/2021 |
| Last Update Date | 10/26/2021 |
| Certification Date | 10/26/2021 |
| Medicare PECOS PAC ID | 3577970045 |
|---|---|
| Medicare Enrollment ID | O20210330000042 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659962041 | NPI | - | NPPES |
| 149.013366 | Other | IL | LCSW149 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Kimberly K Greenlee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679921837 PECOS PAC ID: 5496046112 Enrollment ID: I20160627002078 |
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