| Lindsey Mcclanathan | |
|
6653 Weaver Rd Ste 112 Rockford IL 61114-8052 | |
| (815) 201-2687 | |
| Not Available |
| Full Name | Lindsey Mcclanathan |
|---|---|
| Speciality | Counselor |
| Location | 6653 Weaver Rd Ste 112, Rockford, Illinois |
| Authorized Official Name and Position | Kirsten Ekberg (CONTRACTING) |
| Authorized Official Contact | 8152991955 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lindsey Mcclanathan 6653 Weaver Rd Ste 112 Rockford IL 61114-8052 Ph: () - | Lindsey Mcclanathan 6653 Weaver Rd Ste 112 Rockford IL 61114-8052 Ph: (815) 201-2687 |
| NPI Number | 1952879546 |
|---|---|
| Provider Enumeration Date | 11/13/2018 |
| Last Update Date | 12/22/2020 |
| Certification Date | 12/22/2020 |
| Medicare PECOS PAC ID | 9234544057 |
|---|---|
| Medicare Enrollment ID | O20210209000312 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952879546 | NPI | - | NPPES |
| 311021632001 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| Provider Name | Lindsey Mcclanathan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073991899 PECOS PAC ID: 0143580159 Enrollment ID: I20180213002111 |
| Provider Name | Jamie Swenson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689130742 PECOS PAC ID: 8820403074 Enrollment ID: I20210219001915 |
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