| Lake Behavioral Health Associates, Llc | |
|
7627 Lake St Ste 213 River Forest IL 60305-1878 | |
| (773) 272-1939 | |
| Not Available |
| Full Name | Lake Behavioral Health Associates, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 7627 Lake St Ste 213, River Forest, Illinois |
| Authorized Official Name and Position | Melissa S. Rowland (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 7732721939 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Behavioral Health Associates, Llc 0n071 Myrtle St Winfield IL 60190-1027 Ph: (773) 272-1939 | Lake Behavioral Health Associates, Llc 7627 Lake St Ste 213 River Forest IL 60305-1878 Ph: (773) 272-1939 |
| NPI Number | 1467037754 |
|---|---|
| Provider Enumeration Date | 03/17/2021 |
| Last Update Date | 04/12/2022 |
| Certification Date | 05/14/2021 |
| Medicare PECOS PAC ID | 4688061971 |
|---|---|
| Medicare Enrollment ID | O20220505001611 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467037754 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Melissa S Rowland |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942540869 PECOS PAC ID: 6800023086 Enrollment ID: I20131213000973 |
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