| Waterfall Counseling Llc | |
|
119 Stephen St Lemont IL 60439-3660 | |
| (630) 257-5757 | |
| (630) 257-7055 |
| Full Name | Waterfall Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 119 Stephen St, Lemont, Illinois |
| Authorized Official Name and Position | Susan M Jacobowski (CLINICAL SOCIAL WORKER/MANAGER) |
| Authorized Official Contact | 6302575757 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Waterfall Counseling Llc 119 Stephen St Lemont IL 60439-3660 Ph: (630) 257-5757 | Waterfall Counseling Llc 119 Stephen St Lemont IL 60439-3660 Ph: (630) 257-5757 |
| NPI Number | 1174867048 |
|---|---|
| Provider Enumeration Date | 11/16/2012 |
| Last Update Date | 11/16/2012 |
| Medicare PECOS PAC ID | 9133373731 |
|---|---|
| Medicare Enrollment ID | O20130207000167 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174867048 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149010821 (Illinois) | Primary |
| Provider Name | Susan Mary Jacobowski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811186307 PECOS PAC ID: 9032363635 Enrollment ID: I20130207000179 |
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