| Resilience Counseling | |
|
5844 Elaine Dr Ste 101 Rockford IL 61108-2494 | |
| (815) 373-3027 | |
| Not Available |
| Full Name | Resilience Counseling |
|---|---|
| Speciality | Social Worker |
| Location | 5844 Elaine Dr Ste 101, Rockford, Illinois |
| Authorized Official Name and Position | Renita Shores-gaston (OWNER) |
| Authorized Official Contact | 8155432789 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Resilience Counseling 5844 Elaine Dr Ste 101 Rockford IL 61108-2494 Ph: (815) 373-3027 | Resilience Counseling 5844 Elaine Dr Ste 101 Rockford IL 61108-2494 Ph: (815) 373-3027 |
| NPI Number | 1518421577 |
|---|---|
| Provider Enumeration Date | 01/24/2019 |
| Last Update Date | 09/26/2022 |
| Certification Date | 09/26/2022 |
| Medicare PECOS PAC ID | 0941614705 |
|---|---|
| Medicare Enrollment ID | O20210208000103 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518421577 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Renita Shores-gaston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346614435 PECOS PAC ID: 7618250747 Enrollment ID: I20170215000294 |
| Provider Name | Alanda Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235869280 PECOS PAC ID: 3274918271 Enrollment ID: I20220912001653 |
| Provider Name | Tavares Moore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033627526 PECOS PAC ID: 9931585171 Enrollment ID: I20220926002376 |
| Provider Name | Lisa Marie Dorleans-reyes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205566692 PECOS PAC ID: 7911376231 Enrollment ID: I20221208001915 |
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