| Long Grove Center For Emotional Health Llc | |
|
4180 Rfd Suite 10 Long Grove IL 60047 | |
| (847) 830-8600 | |
| (847) 821-1218 |
| Full Name | Long Grove Center For Emotional Health Llc |
|---|---|
| Speciality | Counselor |
| Location | 4180 Rfd, Long Grove, Illinois |
| Authorized Official Name and Position | Michelle Ann Navarro (LICENSED CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 8478308600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Long Grove Center For Emotional Health Llc 4180 Rfd Suite 10 Long Grove IL 60047 Ph: (847) 830-8600 | Long Grove Center For Emotional Health Llc 4180 Rfd Suite 10 Long Grove IL 60047 Ph: (847) 830-8600 |
| NPI Number | 1790220820 |
|---|---|
| Provider Enumeration Date | 12/28/2016 |
| Last Update Date | 12/28/2016 |
| Medicare PECOS PAC ID | 0042562886 |
|---|---|
| Medicare Enrollment ID | O20181005002520 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790220820 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 071005290 (Illinois) | Primary |
| Provider Name | Ashley Brooke Carson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740730399 PECOS PAC ID: 1850643693 Enrollment ID: I20181005002583 |
| Provider Name | Michelle A Navarro |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043370778 PECOS PAC ID: 7214289057 Enrollment ID: I20181005002653 |
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