| Kp Counseling Ltd | |
|
6392 Linden Rd Rockford IL 61109-2816 | |
| (779) 368-0060 | |
| (815) 368-0579 |
| Full Name | Kp Counseling Ltd |
|---|---|
| Speciality | Social Worker |
| Location | 6392 Linden Rd, Rockford, Illinois |
| Authorized Official Name and Position | Jennifer E Cole Shepard (RCM MGR) |
| Authorized Official Contact | 7633305258 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kp Counseling Ltd 6392 Linden Rd Rockford IL 61109-2816 Ph: (779) 368-0060 | Kp Counseling Ltd 6392 Linden Rd Rockford IL 61109-2816 Ph: (779) 368-0060 |
| NPI Number | 1770630766 |
|---|---|
| Provider Enumeration Date | 01/04/2007 |
| Last Update Date | 10/22/2024 |
| Certification Date | 10/22/2024 |
| Medicare PECOS PAC ID | 1254318983 |
|---|---|
| Medicare Enrollment ID | O20040701000375 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770630766 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149007794 (Illinois) | Primary |
| Provider Name | Kevin M Polky |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902094469 PECOS PAC ID: 2062499791 Enrollment ID: I20040702000218 |
| Provider Name | Kevin D Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578751020 PECOS PAC ID: 2163409509 Enrollment ID: I20040702000379 |
| Provider Name | Christina M Warden |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225371008 PECOS PAC ID: 5890006860 Enrollment ID: I20150617000781 |
| Provider Name | Delinda E Grindle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548631328 PECOS PAC ID: 0749577153 Enrollment ID: I20160929000551 |
| Provider Name | Lindsay N Pozzi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477805828 PECOS PAC ID: 8022374644 Enrollment ID: I20171114001940 |
| Provider Name | Ashley Phillips |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427482397 PECOS PAC ID: 7719298231 Enrollment ID: I20190916000059 |
| Provider Name | Philip L Curtin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265497754 PECOS PAC ID: 5991734089 Enrollment ID: I20191003003622 |
| Provider Name | Ashton R Lockhart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386236990 PECOS PAC ID: 1759760168 Enrollment ID: I20220615001128 |
| Provider Name | Cody Berillo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871292995 PECOS PAC ID: 7012362437 Enrollment ID: I20231004003014 |
| Provider Name | Arianna Calkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750075677 PECOS PAC ID: 9335596386 Enrollment ID: I20231113001736 |
| Provider Name | James R Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083189120 PECOS PAC ID: 7113370289 Enrollment ID: I20240125002251 |
| Provider Name | Sonya Mcdevitt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154803070 PECOS PAC ID: 3173976115 Enrollment ID: I20240126000405 |
| Provider Name | Renae Johnson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1710346689 PECOS PAC ID: 0648623561 Enrollment ID: I20240126003574 |
| Provider Name | George Spangler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710259759 PECOS PAC ID: 6608219282 Enrollment ID: I20240212000264 |
| Provider Name | Timothy Nathan Lewis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629673314 PECOS PAC ID: 1850734328 Enrollment ID: I20240212003193 |
| Provider Name | Nicole Myers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669037933 PECOS PAC ID: 1052754413 Enrollment ID: I20240213002468 |
| Provider Name | Linda Kayser |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790477172 PECOS PAC ID: 2365885738 Enrollment ID: I20240213002689 |
| Provider Name | Karen Lauer |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1982883633 PECOS PAC ID: 6103265632 Enrollment ID: I20240417001873 |
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