| Samudio Counseling Llc | |
|
123 W Washington St Ste 206 Oswego IL 60543-8350 | |
| (630) 647-8282 | |
| (630) 703-1717 |
| Full Name | Samudio Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 123 W Washington St Ste 206, Oswego, Illinois |
| Authorized Official Name and Position | Stephanie Samudio (OWNER) |
| Authorized Official Contact | 6306478282 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Samudio Counseling Llc 123 W Washington St Ste 206 Oswego IL 60543-8350 Ph: (630) 647-8282 | Samudio Counseling Llc 123 W Washington St Ste 206 Oswego IL 60543-8350 Ph: (630) 647-8282 |
| NPI Number | 1558927442 |
|---|---|
| Provider Enumeration Date | 05/15/2019 |
| Last Update Date | 02/02/2023 |
| Certification Date | 02/02/2023 |
| Medicare PECOS PAC ID | 7719344167 |
|---|---|
| Medicare Enrollment ID | O20230531001333 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558927442 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Stephanie L Samudio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023464617 PECOS PAC ID: 1557649969 Enrollment ID: I20170323002591 |
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