| Therapeutic Solutions Of Macomb Llc | |
|
460 S Deer Rd Macomb IL 61455-2602 | |
| (309) 333-9829 | |
| Not Available |
| Full Name | Therapeutic Solutions Of Macomb Llc |
|---|---|
| Speciality | Counselor |
| Location | 460 S Deer Rd, Macomb, Illinois |
| Authorized Official Name and Position | Jennifer Smith (OWNER) |
| Authorized Official Contact | 3095753960 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapeutic Solutions Of Macomb Llc 460 S Deer Rd Macomb IL 61455-2602 Ph: (309) 575-3960 | Therapeutic Solutions Of Macomb Llc 460 S Deer Rd Macomb IL 61455-2602 Ph: (309) 333-9829 |
| NPI Number | 1477308815 |
|---|---|
| Provider Enumeration Date | 04/19/2024 |
| Last Update Date | 09/04/2024 |
| Certification Date | 09/04/2024 |
| Medicare PECOS PAC ID | 1052854288 |
|---|---|
| Medicare Enrollment ID | O20240617001978 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477308815 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Secondary |
| Provider Name | Jennifer Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457578197 PECOS PAC ID: 6507227410 Enrollment ID: I20230725001833 |
| Provider Name | Madeline Bickhaus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083308084 PECOS PAC ID: 2365891967 Enrollment ID: I20231207002884 |
| Provider Name | Amy Renee Hofmeister |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760609507 PECOS PAC ID: 9234590589 Enrollment ID: I20240809002766 |
| Provider Name | Kathy E Lee |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760609416 PECOS PAC ID: 4880132513 Enrollment ID: I20240813003152 |
| Provider Name | Angela Hoyt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477963585 PECOS PAC ID: 1557801065 Enrollment ID: I20240911002386 |
| Provider Name | Kristen Jean Draughan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427423474 PECOS PAC ID: 0446791107 Enrollment ID: I20240920002339 |
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