| Maitri Path To Wellness Pllc | |
|
710 Peoria St Peru IL 61354-3351 | |
| (815) 780-0690 | |
| (815) 410-1937 |
| Full Name | Maitri Path To Wellness Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 710 Peoria St, Peru, Illinois |
| Authorized Official Name and Position | Brenden Fasken (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 8157800690 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maitri Path To Wellness Pllc 710 Peoria St Peru IL 61354-3351 Ph: (815) 780-0690 | Maitri Path To Wellness Pllc 710 Peoria St Peru IL 61354-3351 Ph: (815) 780-0690 |
| NPI Number | 1184204950 |
|---|---|
| Provider Enumeration Date | 04/14/2021 |
| Last Update Date | 04/19/2024 |
| Certification Date | 04/19/2024 |
| Medicare PECOS PAC ID | 5395147714 |
|---|---|
| Medicare Enrollment ID | O20210708000094 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184204950 | NPI | - | NPPES |
| F100761217 | Other | IL | MEDICARE |
| 1184204950 | Medicaid | IL |
| Provider Name | Lisa Kelly Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831692078 PECOS PAC ID: 2567864986 Enrollment ID: I20210708000134 |
Maitri Path To Wellness Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 710 Peoria St, Peru, IL 61354 Phone: 815-780-0690 Fax: 815-410-1937 | |
Youth Service Bureau Of Illinois Valley Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4231 Progress Blvd Ste 1, Peru, IL 61354 Phone: 815-433-3953 Fax: 815-433-3980 | |
Path To Healing And Wellness Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 400 5th St Ste 192, Peru, IL 61354 Phone: 815-303-0718 | |
Wellness And Recovery With Maitri, Inc. Nfp Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 710 Peoria St, Peru, IL 61354 Phone: 815-780-0690 Fax: 815-410-1937 | |
Creating Change Counseling Center Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 5th St Ste 197, Peru, IL 61354 Phone: 815-617-9420 | |
Illinois Valley Autism Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4401 Progress Blvd, Peru, IL 61354 Phone: 815-200-6751 |