| Renee Keller, LCSW | |
|
10551 Vonder Haar Ln, Breese, IL 62230-4316 | |
| (618) 520-3339 | |
| Not Available |
| Full Name | Renee Keller |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 10551 Vonder Haar Ln, Breese, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487841714 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149.015007 (Illinois) | Primary |
| Entity Name | Grow Healthcare Group Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20220414000139 |
| Mailing Address | Practice Location Address |
|---|---|
| Renee Keller, LCSW 10551 Vonder Haar Ln, Breese, IL 62230-4316 Ph: (618) 520-3339 | Renee Keller, LCSW 10551 Vonder Haar Ln, Breese, IL 62230-4316 Ph: (618) 520-3339 |
Mrs. Christina R Diesen, LCSW Clinical Social Worker Medicare: May Accept Medicare Assignments Practice Location: 231 N Main St, Breese, IL 62230 Phone: 618-322-6424 Fax: 618-227-8227 | |
Fred Charles Boch, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 9401 Holy Cross Ln, Suite 112, Breese, IL 62230 Phone: 618-526-7271 Fax: 618-526-7313 | |
Bethany Ricciardi, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1125 N 9th St, Breese, IL 62230 Phone: 618-570-2090 |