| Positively Psyched, Pllc | |
|
17 N Catherine Ave La Grange IL 60525-5929 | |
| (630) 244-2679 | |
| Not Available |
| Full Name | Positively Psyched, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 17 N Catherine Ave, La Grange, Illinois |
| Authorized Official Name and Position | Scott Lestina (OFFICE ADMINISTRATOR) |
| Authorized Official Contact | 6302442679 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Positively Psyched, Pllc 17 N Catherine Ave La Grange IL 60525-5929 Ph: () - | Positively Psyched, Pllc 17 N Catherine Ave La Grange IL 60525-5929 Ph: (630) 244-2679 |
| NPI Number | 1043972854 |
|---|---|
| Provider Enumeration Date | 10/08/2021 |
| Last Update Date | 12/22/2023 |
| Certification Date | 12/22/2023 |
| Medicare PECOS PAC ID | 3274976840 |
|---|---|
| Medicare Enrollment ID | O20240210000648 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043972854 | NPI | - | NPPES |
| 1942667530 | Other | IL | CIGNA/PPO |
| 1942667530 | Other | IL | BCBS/PPO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Megan E Lestina |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942667530 PECOS PAC ID: 0143528414 Enrollment ID: I20160420000653 |
| Provider Name | Thelma M Rodriguez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447907316 PECOS PAC ID: 9537502109 Enrollment ID: I20240210000659 |
| Provider Name | Kristen M Allan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720790611 PECOS PAC ID: 1355784927 Enrollment ID: I20240210000667 |
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