| New Moon Counseling Pllc | |
|
1740 N Maplewood Ave Apt 211 Chicago IL 60647-5281 | |
| (847) 612-9477 | |
| Not Available |
| Full Name | New Moon Counseling Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 1740 N Maplewood Ave Apt 211, Chicago, Illinois |
| Authorized Official Name and Position | Gabrielle L Wolk-phillips (LICENSED CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 8476129477 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Moon Counseling Pllc 1740 N Maplewood Ave Apt 211 Chicago IL 60647-5281 Ph: (847) 612-9477 | New Moon Counseling Pllc 1740 N Maplewood Ave Apt 211 Chicago IL 60647-5281 Ph: (847) 612-9477 |
| NPI Number | 1255078119 |
|---|---|
| Provider Enumeration Date | 05/12/2022 |
| Last Update Date | 05/12/2022 |
| Certification Date | 05/12/2022 |
| Medicare PECOS PAC ID | 5395127641 |
|---|---|
| Medicare Enrollment ID | O20220802003988 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255078119 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Gabrielle L Wolk-phillips |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1669910923 PECOS PAC ID: 6305120726 Enrollment ID: I20170303000570 |
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