| Mj Counseling Ltd | |
|
40w927 Il Route 64 St Charles IL 60175-5314 | |
| (310) 993-5230 | |
| Not Available |
| Full Name | Mj Counseling Ltd |
|---|---|
| Speciality | Clinic/Center |
| Location | 40w927 Il Route 64, St Charles, Illinois |
| Authorized Official Name and Position | Marissa Jepsen (PRESIDENT) |
| Authorized Official Contact | 3109935230 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mj Counseling Ltd 40w927 Il Route 64 St Charles IL 60175-5314 Ph: (310) 993-5230 | Mj Counseling Ltd 40w927 Il Route 64 St Charles IL 60175-5314 Ph: (310) 993-5230 |
| NPI Number | 1982482725 |
|---|---|
| Provider Enumeration Date | 09/21/2023 |
| Last Update Date | 09/21/2023 |
| Certification Date | 09/21/2023 |
| Medicare PECOS PAC ID | 0547616583 |
|---|---|
| Medicare Enrollment ID | O20231026002354 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982482725 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Marissa Jepsen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659021996 PECOS PAC ID: 2567838550 Enrollment ID: I20221017000567 |
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