| Mrb Counseling, Sc | |
|
977 Lakeview Pkwy #155 Vernon Hills IL 60061-1400 | |
| (847) 918-0129 | |
| (847) 918-0747 |
| Full Name | Mrb Counseling, Sc |
|---|---|
| Speciality | Social Worker |
| Location | 977 Lakeview Pkwy, Vernon Hills, Illinois |
| Authorized Official Name and Position | Michael R Bourbon (PRESIDENT) |
| Authorized Official Contact | 8479180129 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mrb Counseling, Sc 977 Lakeview Pkwy #155 Vernon Hills IL 60061-1400 Ph: (847) 918-0129 | Mrb Counseling, Sc 977 Lakeview Pkwy #155 Vernon Hills IL 60061-1400 Ph: (847) 918-0129 |
| NPI Number | 1003981192 |
|---|---|
| Provider Enumeration Date | 11/22/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 3274424288 |
|---|---|
| Medicare Enrollment ID | O20040322000096 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003981192 | NPI | - | NPPES |
| 1632567 | Other | IL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (Illinois) | Primary |
| Provider Name | Michael R Bourbon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316012537 PECOS PAC ID: 2163313172 Enrollment ID: I20040322000133 |
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