|
| |
|
333 N Michigan Ave Ste 1810 Chicago IL 60601-3983 | |
| (855) 284-7483 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 333 N Michigan Ave Ste 1810, Chicago, Illinois |
| Authorized Official Name and Position | Anthony Centore (CEO) |
| Authorized Official Contact | 5402176461 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1000 Jefferson St Ste 2c Lynchburg VA 24504-1724 Ph: (540) 217-6461 | 333 N Michigan Ave Ste 1810 Chicago IL 60601-3983 Ph: (855) 284-7483 |
| NPI Number | 1164190633 |
|---|---|
| Provider Enumeration Date | 08/31/2021 |
| Last Update Date | 03/29/2022 |
| Certification Date | 03/29/2022 |
| Medicare PECOS PAC ID | 6800263823 |
|---|---|
| Medicare Enrollment ID | O20221104000575 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164190633 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Barbara E Webb |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760481774 PECOS PAC ID: 9537143128 Enrollment ID: I20040614000058 |
| Provider Name | Susan E Zeitner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174861736 PECOS PAC ID: 7113163080 Enrollment ID: I20130419000153 |
| Provider Name | Christina Marie Geiselhart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639476120 PECOS PAC ID: 7012159007 Enrollment ID: I20130802000854 |
| Provider Name | Dominika Ventucci |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558865741 PECOS PAC ID: 9234493354 Enrollment ID: I20180425002490 |
| Provider Name | Bianca Jasmin Clark |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700444320 PECOS PAC ID: 5496082919 Enrollment ID: I20190807000026 |
| Provider Name | Brittany M Lafin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699163287 PECOS PAC ID: 7214320720 Enrollment ID: I20220204001752 |
| Provider Name | Nina Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639359698 PECOS PAC ID: 6507083896 Enrollment ID: I20220512000929 |
| Provider Name | Debra H Honig |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740743509 PECOS PAC ID: 6305213240 Enrollment ID: I20221104001595 |
| Provider Name | Gary T Zurawski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144534728 PECOS PAC ID: 6002283942 Enrollment ID: I20221104001742 |
| Provider Name | Frederick A Smith |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1568971091 PECOS PAC ID: 7517334469 Enrollment ID: I20221104001910 |
| Provider Name | Danielle Yvette Jacobson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376249912 PECOS PAC ID: 3971976564 Enrollment ID: I20230301002319 |
| Provider Name | Amy T Marshman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528218427 PECOS PAC ID: 4082070560 Enrollment ID: I20230525003265 |
| Provider Name | Emily Grace Ellsworth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356024707 PECOS PAC ID: 5991168213 Enrollment ID: I20230901002570 |
| Provider Name | Jasmine Nicole Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821873076 PECOS PAC ID: 5496119091 Enrollment ID: I20230915000367 |
| Provider Name | Dawn Vance |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013238005 PECOS PAC ID: 3678924941 Enrollment ID: I20240111000242 |
| Provider Name | Shah Hasan |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1205492907 PECOS PAC ID: 5799152716 Enrollment ID: I20240111001227 |
| Provider Name | Erin Wold |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316598550 PECOS PAC ID: 3678924974 Enrollment ID: I20240111001495 |
| Provider Name | Esther Ruiz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174285035 PECOS PAC ID: 4789035916 Enrollment ID: I20240111003018 |
| Provider Name | Stephanie Haywood |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710538368 PECOS PAC ID: 4587015714 Enrollment ID: I20240111003124 |
| Provider Name | David Fletcher-janzen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215604509 PECOS PAC ID: 9931339447 Enrollment ID: I20240111003910 |
| Provider Name | Gloria Wright |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598978389 PECOS PAC ID: 9234580408 Enrollment ID: I20240111004664 |
| Provider Name | Tracey Ben Shalom |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265908230 PECOS PAC ID: 7719338912 Enrollment ID: I20240112000652 |
| Provider Name | Chelsea Parkinson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285355354 PECOS PAC ID: 2466803580 Enrollment ID: I20240112001350 |
| Provider Name | Jenelle Thompson-keene |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174208581 PECOS PAC ID: 4688026677 Enrollment ID: I20240116000084 |
| Provider Name | Taylor Barton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770254450 PECOS PAC ID: 9830541713 Enrollment ID: I20240116003257 |
| Provider Name | Logan Spicer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770140949 PECOS PAC ID: 1658723564 Enrollment ID: I20240116003945 |
| Provider Name | Chelsea Webb |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1639880305 PECOS PAC ID: 2264884014 Enrollment ID: I20240117004556 |
| Provider Name | Nancy Fredrick |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457774390 PECOS PAC ID: 5799137352 Enrollment ID: I20240118003748 |
| Provider Name | Joseph Ryan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740890813 PECOS PAC ID: 4587016183 Enrollment ID: I20240119000203 |
| Provider Name | Erin Taylor |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265660658 PECOS PAC ID: 6406205020 Enrollment ID: I20240130002874 |
| Provider Name | Ralph Salvatore Pollaro |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265667679 PECOS PAC ID: 4082067475 Enrollment ID: I20240201002909 |
| Provider Name | Emily Sherrill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235651738 PECOS PAC ID: 7810330248 Enrollment ID: I20240213001077 |
| Provider Name | Jessica Elizabeth Beaston |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952628364 PECOS PAC ID: 8224472741 Enrollment ID: I20240222003358 |
| Provider Name | Rebekah Denise Wendling |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578233847 PECOS PAC ID: 8426493305 Enrollment ID: I20240301000986 |
| Provider Name | Emily Kristine Heming |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558125146 PECOS PAC ID: 7911343454 Enrollment ID: I20240307000402 |
| Provider Name | Krystle Kellick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477328417 PECOS PAC ID: 4183062334 Enrollment ID: I20240405003148 |
| Provider Name | Rebecca Maple |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568046381 PECOS PAC ID: 1052706074 Enrollment ID: I20240417000098 |
| Provider Name | Marc Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275391617 PECOS PAC ID: 7214377159 Enrollment ID: I20240425002975 |
| Provider Name | Nevida Khetarpal |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1609398353 PECOS PAC ID: 7012357890 Enrollment ID: I20240426000966 |
| Provider Name | Kelly Ellison |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851953913 PECOS PAC ID: 2365884137 Enrollment ID: I20240524000252 |
| Provider Name | Luana Lienhart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376962985 PECOS PAC ID: 8426590787 Enrollment ID: I20240603001893 |
| Provider Name | Amber Williams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124712468 PECOS PAC ID: 3375085160 Enrollment ID: I20240607002390 |
| Provider Name | Sebin Jose |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457190332 PECOS PAC ID: 1557806460 Enrollment ID: I20240716002341 |
| Provider Name | Michelle Zambrano |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184757916 PECOS PAC ID: 1557807336 Enrollment ID: I20240729003421 |
| Provider Name | Daiva Karuza |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902086739 PECOS PAC ID: 2961949276 Enrollment ID: I20240805002160 |
| Provider Name | Marissa Hatcher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134968498 PECOS PAC ID: 9436696572 Enrollment ID: I20240806004366 |
| Provider Name | Kimberly Spencer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437787876 PECOS PAC ID: 7810428927 Enrollment ID: I20241001000037 |
| Provider Name | Michelle N Barraco Hatchett |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881944650 PECOS PAC ID: 7810301397 Enrollment ID: I20241003000952 |
Philip K Mccullough Md Sc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 E Huron St, Suite 11-100, Chicago, IL 60611 Phone: 312-695-3680 Fax: 312-926-3709 | |
Amy Lynn, Lcpc, Atr Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3020 N Lincoln Ave, Flourish Studios, Chicago, IL 60657 Phone: 773-746-7429 | |
K.a.m Alliance, Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2215 W 95th St Ste 100, Chicago, IL 60643 Phone: 773-239-9600 Fax: 773-239-9601 | |
King Community Mental Health Center Corp Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4455 S King Drive, Suite 101, Chicago, IL 60653 Phone: 773-536-2700 Fax: 773-751-2250 | |
Professional Diagnostic Service, S.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 821 W Van Buren St, Chicago, IL 60607 Phone: 312-491-0404 Fax: 312-491-0505 | |
Universal Medical Group Ltd. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 809 E 42nd Pl, Chicago, IL 60653 Phone: 773-285-3422 |