| Professional Counseling Services Ltd | |
|
17732 Oak Park Avenue Tinley Park IL 60477 | |
| (708) 342-1773 | |
| (708) 342-1780 |
| Full Name | Professional Counseling Services Ltd |
|---|---|
| Speciality | Clinic/Center |
| Location | 17732 Oak Park Avenue, Tinley Park, Illinois |
| Authorized Official Name and Position | Diane Nicholas (OFFICE MANAGER) |
| Authorized Official Contact | 7083421773 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Counseling Services Ltd 17732 Oak Park Avenue Tinley Park IL 60477 Ph: (708) 342-1773 | Professional Counseling Services Ltd 17732 Oak Park Avenue Tinley Park IL 60477 Ph: (708) 342-1773 |
| NPI Number | 1093884587 |
|---|---|
| Provider Enumeration Date | 11/07/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 9830386911 |
|---|---|
| Medicare Enrollment ID | O20101215000737 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093884587 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Daniel Brian Nicholas |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1568544740 PECOS PAC ID: 0749477826 Enrollment ID: I20101215000777 |
| Provider Name | Lynn Wachtel-shapiro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003998204 PECOS PAC ID: 3779767579 Enrollment ID: I20110401000517 |
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