| Willow Creek Counseling Llc | |
|
5906 Elaine Dr Ste 103 Rockford IL 61108-2467 | |
| (779) 210-3453 | |
| Not Available |
| Full Name | Willow Creek Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 5906 Elaine Dr Ste 103, Rockford, Illinois |
| Authorized Official Name and Position | Julie Rylatt (OWNER) |
| Authorized Official Contact | 8159787844 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Willow Creek Counseling Llc 5906 Elaine Dr Ste 103 Rockford IL 61108-2467 Ph: (779) 210-3453 | Willow Creek Counseling Llc 5906 Elaine Dr Ste 103 Rockford IL 61108-2467 Ph: (779) 210-3453 |
| NPI Number | 1144941394 |
|---|---|
| Provider Enumeration Date | 09/07/2022 |
| Last Update Date | 09/07/2022 |
| Certification Date | 09/07/2022 |
| Medicare PECOS PAC ID | 8325415102 |
|---|---|
| Medicare Enrollment ID | O20221108001615 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144941394 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Bridget Denise Mcknight |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568006096 PECOS PAC ID: 8729412812 Enrollment ID: I20191224000603 |
| Provider Name | Julie Rylatt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851836696 PECOS PAC ID: 1052742988 Enrollment ID: I20200511000046 |
| Provider Name | Nancy K West |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831782440 PECOS PAC ID: 5496122210 Enrollment ID: I20221108003191 |
| Provider Name | Jennifer Reyes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982330163 PECOS PAC ID: 5395113724 Enrollment ID: I20221116001210 |
| Provider Name | Jennifer Zaluckyj |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184297517 PECOS PAC ID: 7416325857 Enrollment ID: I20221116001824 |
| Provider Name | Matthew Louis Pearlman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083473979 PECOS PAC ID: 7012355126 Enrollment ID: I20240409003291 |
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