| White Stone Partners Llc | |
|
100 N Waukegan Rd Ste 204 Lake Bluff IL 60044-1660 | |
| (847) 461-9162 | |
| Not Available |
| Full Name | White Stone Partners Llc |
|---|---|
| Speciality | Counselor |
| Location | 100 N Waukegan Rd Ste 204, Lake Bluff, Illinois |
| Authorized Official Name and Position | Camille Elizabeth Andress (OWNER) |
| Authorized Official Contact | 8473096216 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| White Stone Partners Llc 100 N Waukegan Rd Ste 204 Lake Bluff IL 60044-1660 Ph: () - | White Stone Partners Llc 100 N Waukegan Rd Ste 204 Lake Bluff IL 60044-1660 Ph: (847) 461-9162 |
| NPI Number | 1801543616 |
|---|---|
| Provider Enumeration Date | 03/02/2022 |
| Last Update Date | 03/02/2022 |
| Certification Date | 03/02/2022 |
| Medicare PECOS PAC ID | 2163873803 |
|---|---|
| Medicare Enrollment ID | O20240108003601 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801543616 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Camille Elizabeth Andress |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346612389 PECOS PAC ID: 3971954629 Enrollment ID: I20240108003951 |
| Provider Name | Jenean Louise Moore |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164822532 PECOS PAC ID: 9739530387 Enrollment ID: I20240108004226 |
| Provider Name | Jonathan Noto |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427582162 PECOS PAC ID: 6608227350 Enrollment ID: I20240207000199 |
| Provider Name | Luis San Roman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124480595 PECOS PAC ID: 8325499072 Enrollment ID: I20240212001898 |
| Provider Name | Mark Joseph Starczynski |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437649324 PECOS PAC ID: 8729421169 Enrollment ID: I20240213001528 |
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