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1431 Lourdes Rd Metamora IL 61548-7609 | |
| (309) 383-4323 | |
| (309) 383-3399 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 1431 Lourdes Rd, Metamora, Illinois |
| Authorized Official Name and Position | Julie Elise Sellner (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3093834323 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1431 Lourdes Rd Metamora IL 61548-7609 Ph: (309) 383-4323 | 1431 Lourdes Rd Metamora IL 61548-7609 Ph: (309) 383-4323 |
| NPI Number | 1922283464 |
|---|---|
| Provider Enumeration Date | 01/03/2008 |
| Last Update Date | 07/10/2024 |
| Certification Date | 07/10/2024 |
| Medicare PECOS PAC ID | 7315483245 |
|---|---|
| Medicare Enrollment ID | O20240726002139 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922283464 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 180005723 (Illinois) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
| Provider Name | Michelle Alcorn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427642826 PECOS PAC ID: 2668820200 Enrollment ID: I20240215000348 |
| Provider Name | Julie E Sellner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1972657732 PECOS PAC ID: 8224574157 Enrollment ID: I20240726002233 |
New Heights Counseling Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 610 State Route 116, Metamora, IL 61548 Phone: 309-840-3885 |