| Woodstock Therapist Llc | |
|
224 W Judd St Woodstock IL 60098-3199 | |
| (815) 345-3400 | |
| (844) 734-1259 |
| Full Name | Woodstock Therapist Llc |
|---|---|
| Speciality | Counselor |
| Location | 224 W Judd St, Woodstock, Illinois |
| Authorized Official Name and Position | Lindsay Keisman (OWNER/THERAPIST) |
| Authorized Official Contact | 8153453400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Woodstock Therapist Llc 224 W Judd St Woodstock IL 60098-3199 Ph: (815) 236-3272 | Woodstock Therapist Llc 224 W Judd St Woodstock IL 60098-3199 Ph: (815) 345-3400 |
| NPI Number | 1003358037 |
|---|---|
| Provider Enumeration Date | 11/08/2016 |
| Last Update Date | 02/23/2024 |
| Certification Date | 02/23/2024 |
| Medicare PECOS PAC ID | 6507133105 |
|---|---|
| Medicare Enrollment ID | O20170602001149 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003358037 | NPI | - | NPPES |
| Provider Name | Katharine L Hansen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376933952 PECOS PAC ID: 0345568705 Enrollment ID: I20150414002706 |
| Provider Name | Amber Nicole Meeke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265102867 PECOS PAC ID: 4981072261 Enrollment ID: I20221117000104 |
| Provider Name | Richard Lee Mccoy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790111631 PECOS PAC ID: 1153771357 Enrollment ID: I20240101000141 |
| Provider Name | Brian Smith Mccallum |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962775734 PECOS PAC ID: 2860845773 Enrollment ID: I20240126003387 |
| Provider Name | Breanne Pfrank |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598296287 PECOS PAC ID: 7810330867 Enrollment ID: I20240207001837 |
| Provider Name | Kyle Joseph Saunders |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568024982 PECOS PAC ID: 0941644389 Enrollment ID: I20240214000349 |
| Provider Name | Erin Brumfield Grima |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508146218 PECOS PAC ID: 8426492794 Enrollment ID: I20240215000748 |
| Provider Name | Shira R Greenfield |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356340665 PECOS PAC ID: 2860836590 Enrollment ID: I20240221000736 |
| Provider Name | Manette Tomlinson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558848390 PECOS PAC ID: 7719322932 Enrollment ID: I20240228000317 |
| Provider Name | Rebecca Esser |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831613892 PECOS PAC ID: 4981049087 Enrollment ID: I20240228003427 |
| Provider Name | Lindsay Keisman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912298134 PECOS PAC ID: 6406123009 Enrollment ID: I20240301000222 |
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