| Ms Juliet Ann Russom Walden, BS, AM, LSCW | |
|
13136 Western Ave, Blue Island, IL 60406-2423 | |
| (708) 974-5800 | |
| Not Available |
| Full Name | Ms Juliet Ann Russom Walden |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 13136 Western Ave, Blue Island, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154614634 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149.014305 (Illinois) | Primary |
| Entity Name | Kp Counseling Ltd |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770630766 PECOS PAC ID: 1254318983 Enrollment ID: O20040701000375 |
| Entity Name | Optum Behavioral Care Therapy Services Of Illinois Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235949553 PECOS PAC ID: 2163944190 Enrollment ID: O20250319003644 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Juliet Ann Russom Walden, BS, AM, LSCW 1945 W 22nd Pl, Chicago, IL 60608-4205 Ph: (773) 247-6689 | Ms Juliet Ann Russom Walden, BS, AM, LSCW 13136 Western Ave, Blue Island, IL 60406-2423 Ph: (708) 974-5800 |
Amanda Keenan, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 3046 127th St, Blue Island, IL 60406 Phone: 708-377-7920 Fax: 708-930-0414 | |
Kristen Hofman, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 13136 Western Ave, Blue Island, IL 60406 Phone: 708-974-5800 | |
Jessica Null, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 12331 Gregory St, Blue Island, IL 60406 Phone: 708-489-7338 | |
Mr. George Fay Henry Jr., LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 12311 Meadow Ln, Unit 1b, Blue Island, IL 60406 Phone: 312-504-5560 | |
Mr. Leo W Lavender, Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 13811 Western Ave, Blue Island, IL 60406 Phone: 773-552-4120 | |
Candace Clark, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 13136 Western Ave, Blue Island, IL 60406 Phone: 708-974-5864 |