| The Center For Courageous Living Llc | |
|
475 W Terra Cotta Ave Ste E Crystal Lake IL 60014-3407 | |
| (815) 707-4806 | |
| (815) 977-8715 |
| Full Name | The Center For Courageous Living Llc |
|---|---|
| Speciality | Social Worker |
| Location | 475 W Terra Cotta Ave Ste E, Crystal Lake, Illinois |
| Authorized Official Name and Position | Katie (kathleen) M Kroening (COUNSELOR/OWNDER) |
| Authorized Official Contact | 8157074806 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Center For Courageous Living Llc 475 W Terra Cotta Ave Ste E Crystal Lake IL 60014-3407 Ph: (815) 707-4806 | The Center For Courageous Living Llc 475 W Terra Cotta Ave Ste E Crystal Lake IL 60014-3407 Ph: (815) 707-4806 |
| NPI Number | 1457842460 |
|---|---|
| Provider Enumeration Date | 05/24/2018 |
| Last Update Date | 12/13/2022 |
| Certification Date | 01/25/2021 |
| Medicare PECOS PAC ID | 7113350612 |
|---|---|
| Medicare Enrollment ID | O20191213000011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457842460 | NPI | - | NPPES |
| Provider Name | Melissa M Bachelder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659743946 PECOS PAC ID: 2062700701 Enrollment ID: I20161012000355 |
| Provider Name | Kathleen M Kroening |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548718844 PECOS PAC ID: 9931533379 Enrollment ID: I20191218001276 |
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