| Sophron Counseling Services, Pllc | |
|
187 S Indiana Ave Ste 307 Kankakee IL 60901-3645 | |
| (815) 408-1262 | |
| (815) 401-7684 |
| Full Name | Sophron Counseling Services, Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 187 S Indiana Ave Ste 307, Kankakee, Illinois |
| Authorized Official Name and Position | Tracy R Mckenney (OWNER) |
| Authorized Official Contact | 8154081262 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sophron Counseling Services, Pllc 187 S Indiana Ave Ste 307 Kankakee IL 60901-3645 Ph: (815) 408-1262 | Sophron Counseling Services, Pllc 187 S Indiana Ave Ste 307 Kankakee IL 60901-3645 Ph: (815) 408-1262 |
| NPI Number | 1477389716 |
|---|---|
| Provider Enumeration Date | 09/12/2024 |
| Last Update Date | 09/12/2024 |
| Certification Date | 09/11/2024 |
| Medicare PECOS PAC ID | 0345773289 |
|---|---|
| Medicare Enrollment ID | O20241030001709 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477389716 | NPI | - | NPPES |
| Provider Name | Tracy R Mckenney |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962068577 PECOS PAC ID: 1254864192 Enrollment ID: I20241030001817 |
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