| Tonya L. Bassett Counseling, Inc | |
|
200 W Monroe St Ste 25 Suite 302-a Bloomington IL 61701-3922 | |
| (309) 831-9558 | |
| Not Available |
| Full Name | Tonya L. Bassett Counseling, Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 200 W Monroe St Ste 25, Bloomington, Illinois |
| Authorized Official Name and Position | Tonya Lynn Bassett (OWNER) |
| Authorized Official Contact | 3098319558 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tonya L. Bassett Counseling, Inc 200 W Monroe St Ste 25 Suite 302-a Bloomington IL 61701-3922 Ph: (309) 831-9558 | Tonya L. Bassett Counseling, Inc 200 W Monroe St Ste 25 Suite 302-a Bloomington IL 61701-3922 Ph: (309) 831-9558 |
| NPI Number | 1245786698 |
|---|---|
| Provider Enumeration Date | 08/26/2016 |
| Last Update Date | 08/26/2016 |
| Medicare PECOS PAC ID | 2466749833 |
|---|---|
| Medicare Enrollment ID | O20160928002219 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245786698 | NPI | - | NPPES |
| 1041C0700X | Other | IL | LICENSED CLINICAL SOCIAL WORKER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 149013779 (Illinois) | Primary |
| Provider Name | Tonya Lynn Bassett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821281429 PECOS PAC ID: 9133267164 Enrollment ID: I20091112000314 |
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