| The Kennedy Center For Counseling, P.c. | |
|
305 N Vine St Unit 201 New Lenox IL 60451-1652 | |
| (815) 320-3749 | |
| (815) 320-3825 |
| Full Name | The Kennedy Center For Counseling, P.c. |
|---|---|
| Speciality | Counselor |
| Location | 305 N Vine St Unit 201, New Lenox, Illinois |
| Authorized Official Name and Position | Rita Kennedy (PRESIDENT) |
| Authorized Official Contact | 8153203749 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Kennedy Center For Counseling, P.c. 305 N Vine St Unit 201 New Lenox IL 60451-1652 Ph: (815) 258-9733 | The Kennedy Center For Counseling, P.c. 305 N Vine St Unit 201 New Lenox IL 60451-1652 Ph: (815) 320-3749 |
| NPI Number | 1538569058 |
|---|---|
| Provider Enumeration Date | 09/03/2014 |
| Last Update Date | 04/19/2024 |
| Certification Date | 04/19/2024 |
| Medicare PECOS PAC ID | 5496052656 |
|---|---|
| Medicare Enrollment ID | O20160401001856 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538569058 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 180.007398 (Illinois) | Primary |
| Provider Name | Jamilah Akbar |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356755540 PECOS PAC ID: 2466996855 Enrollment ID: I20240626002799 |
| Provider Name | Laura Jackman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003067307 PECOS PAC ID: 7416491816 Enrollment ID: I20240626002940 |
| Provider Name | Annette Krason |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952774713 PECOS PAC ID: 8123562527 Enrollment ID: I20240626003005 |
| Provider Name | Rita L Sanders |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154576452 PECOS PAC ID: 9830496090 Enrollment ID: I20240711003679 |
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