| Releve Counseling Llc | |
|
4615 E State St Ste 204 Rockford IL 61108-2158 | |
| (815) 708-9068 | |
| (779) 970-5908 |
| Full Name | Releve Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 4615 E State St Ste 204, Rockford, Illinois |
| Authorized Official Name and Position | Joanna Marie De Leon (OWNER/CLINICAL SUPERVISOR) |
| Authorized Official Contact | 8157089068 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Releve Counseling Llc 4615 E State St Ste 204 Rockford IL 61108-2158 Ph: (815) 708-9068 | Releve Counseling Llc 4615 E State St Ste 204 Rockford IL 61108-2158 Ph: (815) 708-9068 |
| NPI Number | 1982350252 |
|---|---|
| Provider Enumeration Date | 02/25/2022 |
| Last Update Date | 04/30/2024 |
| Certification Date | 07/13/2022 |
| Medicare PECOS PAC ID | 2860831831 |
|---|---|
| Medicare Enrollment ID | O20240424000110 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982350252 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Joanna Marie Dy De Leon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194362947 PECOS PAC ID: 4688013659 Enrollment ID: I20240424000134 |
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