| Melissa Shane Counseling Services Llc | |
|
6919 N Knoxville Ave Ste 100 Peoria IL 61614-2858 | |
| (309) 369-3498 | |
| (309) 966-0266 |
| Full Name | Melissa Shane Counseling Services Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 6919 N Knoxville Ave Ste 100, Peoria, Illinois |
| Authorized Official Name and Position | Melissa Ann Shane (OWNER) |
| Authorized Official Contact | 3093693498 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Melissa Shane Counseling Services Llc 6919 N Knoxville Ave Ste 100 Peoria IL 61614-2858 Ph: (309) 369-3498 | Melissa Shane Counseling Services Llc 6919 N Knoxville Ave Ste 100 Peoria IL 61614-2858 Ph: (309) 369-3498 |
| NPI Number | 1083125298 |
|---|---|
| Provider Enumeration Date | 10/14/2017 |
| Last Update Date | 10/14/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083125298 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 180008837 (Illinois) | Primary |
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