| Partnerships In Behavioral Health | |
|
9933 S Western Ave Ste 203 Chicago IL 60643-1810 | |
| (312) 730-3966 | |
| (312) 803-1635 |
| Full Name | Partnerships In Behavioral Health |
|---|---|
| Speciality | Psychologist |
| Location | 9933 S Western Ave Ste 203, Chicago, Illinois |
| Authorized Official Name and Position | Nicole Thomas (OPERATIONS DIRECTOR) |
| Authorized Official Contact | 3127303966 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Partnerships In Behavioral Health 9933 S Western Ave Ste 203 Chicago IL 60643-1810 Ph: (312) 730-3966 | Partnerships In Behavioral Health 9933 S Western Ave Ste 203 Chicago IL 60643-1810 Ph: (312) 730-3966 |
| NPI Number | 1437667805 |
|---|---|
| Provider Enumeration Date | 01/18/2018 |
| Last Update Date | 11/10/2023 |
| Certification Date | 11/10/2023 |
| Medicare PECOS PAC ID | 9335495944 |
|---|---|
| Medicare Enrollment ID | O20180711002390 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437667805 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 071009102 (Illinois) | Primary |
| 1041C0700X | Social Worker - Clinical | 149008520 (Illinois) | Secondary |
| Provider Name | Latreece E Dickerson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1053409722 PECOS PAC ID: 0042445769 Enrollment ID: I20180531002948 |
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