Real Life Counseling, Pllc | |
360 Memorial Dr Crystal Lake IL 60014-6291 | |
(847) 754-7398 | |
Not Available |
Full Name | Real Life Counseling, Pllc |
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Speciality | Counselor |
Location | 360 Memorial Dr, Crystal Lake, Illinois |
Authorized Official Name and Position | Jeanne Coulson (OWNER) |
Authorized Official Contact | 8477547398 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Real Life Counseling, Pllc 638 Vine St Hampshire IL 60140-5620 Ph: (847) 754-7398 | Real Life Counseling, Pllc 360 Memorial Dr Crystal Lake IL 60014-6291 Ph: (847) 754-7398 |
NPI Number | 1558936773 |
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Provider Enumeration Date | 05/20/2021 |
Last Update Date | 09/27/2024 |
Certification Date | 09/27/2024 |
Medicare PECOS PAC ID | 0941642557 |
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Medicare Enrollment ID | O20240529000646 |
Identifier | Type | State | Issuer |
---|---|---|---|
1558936773 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
Provider Name | Jeanne Coulson |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1972959377 PECOS PAC ID: 5092157602 Enrollment ID: I20240529000860 |
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