| Live Well Counseling Services | |
|
13317 County Highway 12 Venedy IL 62214-1103 | |
| (618) 317-1537 | |
| Not Available |
| Full Name | Live Well Counseling Services |
|---|---|
| Speciality | Social Worker |
| Location | 13317 County Highway 12, Venedy, Illinois |
| Authorized Official Name and Position | Bethany Raye Borrenpohl (OWNER) |
| Authorized Official Contact | 6183171537 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Live Well Counseling Services 13317 County Highway 12 Venedy IL 62214-1103 Ph: (618) 317-1537 | Live Well Counseling Services 13317 County Highway 12 Venedy IL 62214-1103 Ph: (618) 317-1537 |
| NPI Number | 1881055838 |
|---|---|
| Provider Enumeration Date | 03/17/2016 |
| Last Update Date | 04/30/2020 |
| Certification Date | 04/30/2020 |
| Medicare PECOS PAC ID | 5991002420 |
|---|---|
| Medicare Enrollment ID | O20160329002203 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881055838 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149.017552 (Illinois) | Primary |
| Provider Name | Rose Margaret Lafferty |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538104708 PECOS PAC ID: 9739361411 Enrollment ID: I20110317000136 |
| Provider Name | Valerie A Duff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457725459 PECOS PAC ID: 7810299195 Enrollment ID: I20160104000585 |
| Provider Name | Bethany Raye Borrenpohl |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861860124 PECOS PAC ID: 6800193335 Enrollment ID: I20160329002367 |
| Provider Name | Carolyn Sue Endicott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013135011 PECOS PAC ID: 8426314972 Enrollment ID: I20171116000043 |
| Provider Name | Cynthia Louise Kieffer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427546001 PECOS PAC ID: 5092055202 Enrollment ID: I20190326003056 |
| Provider Name | Tonia D. Short |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891952560 PECOS PAC ID: 3072662352 Enrollment ID: I20190411000648 |
| Provider Name | Nancy El Leefers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902459597 PECOS PAC ID: 9436489200 Enrollment ID: I20190920000028 |
| Provider Name | Jessica Beasley Gunther |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417596156 PECOS PAC ID: 1658706791 Enrollment ID: I20200117000011 |
| Provider Name | Laura Beth Marcum |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881207884 PECOS PAC ID: 2264850957 Enrollment ID: I20200911001904 |
| Provider Name | Tiffany Nicole Shurtz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467112417 PECOS PAC ID: 6002200888 Enrollment ID: I20220221000700 |
| Provider Name | Ariel Michelle Mann |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033849641 PECOS PAC ID: 9739564238 Enrollment ID: I20220920001964 |
| Provider Name | Bonnie Katherine Shelton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821541574 PECOS PAC ID: 4486003639 Enrollment ID: I20231213000995 |
| Provider Name | Anne Marie Calvert |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861027724 PECOS PAC ID: 8921441643 Enrollment ID: I20240209002485 |