|
| |
|
1818 Logan Ave Belvidere IL 61008-6412 | |
| (815) 575-9887 | |
| (815) 534-1437 |
| Full Name | |
|---|---|
| Speciality | Social Worker |
| Location | 1818 Logan Ave, Belvidere, Illinois |
| Authorized Official Name and Position | Shelli L Pollard (OWNER) |
| Authorized Official Contact | 8155759887 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1818 Logan Ave Belvidere IL 61008-6412 Ph: (815) 575-9887 | 1818 Logan Ave Belvidere IL 61008-6412 Ph: (815) 575-9887 |
| NPI Number | 1780446476 |
|---|---|
| Provider Enumeration Date | 01/29/2024 |
| Last Update Date | 01/09/2025 |
| Certification Date | 01/09/2025 |
| Medicare PECOS PAC ID | 7618312711 |
|---|---|
| Medicare Enrollment ID | O20240228003395 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780446476 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Shelli Pollard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053786269 PECOS PAC ID: 2567724479 Enrollment ID: I20180313000029 |
Linda Kyle Rimkus Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9570 Perrett Ln, Belvidere, IL 61008 Phone: 815-262-0146 Fax: 815-544-3392 | |
Janet Wattles Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 475 Southtowne Dr, Belvidere, IL 61008 Phone: 815-544-4849 | |
Brightside Recovery Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1667 Belvidere Rd, Belvidere, IL 61008 Phone: 779-237-3550 Fax: 224-205-7866 | |
Bridge Life Counseling, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1120 Fremont St, Belvidere, IL 61008 Phone: 779-537-8544 | |
Remedies Renewing Lives Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1908 Pierce Ct, Belvidere, IL 61008 Phone: 815-547-4502 Fax: 815-544-0391 | |