| Ms Michelle L Petty, MS, LCPC, NCC | |
|
11447 2nd St, Roscoe, IL 61073-9522 | |
| (815) 979-1085 | |
| Not Available |
| Full Name | Ms Michelle L Petty |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 11447 2nd St, Roscoe, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598030801 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 178.007926 (Illinois) | Secondary |
| 101YP2500X | Counselor - Professional | 180.009475 (Illinois) | Primary |
| Entity Name | Alternative Wellness Therapies Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144802794 PECOS PAC ID: 8628505823 Enrollment ID: O20241230003257 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Michelle L Petty, MS, LCPC, NCC 11447 2nd St, Roscoe, IL 61073-9522 Ph: (815) 979-1085 | Ms Michelle L Petty, MS, LCPC, NCC 11447 2nd St, Roscoe, IL 61073-9522 Ph: (815) 979-1085 |
Joseph T Marella, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 11447 2nd St Ste 9b, Roscoe, IL 61073 Phone: 815-601-4673 Fax: 866-303-8062 | |
Jamie R Wagner, LCPC, LPC, RPT-S Counselor Medicare: Not Enrolled in Medicare Practice Location: 11447 2nd St, Suite 9b, Roscoe, IL 61073 Phone: 815-601-4673 Fax: 866-303-8062 | |
Mrs. Amanda Dee Musfelt, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 5290 Williams Dr, Roscoe, IL 61073 Phone: 815-324-0324 | |
Mrs. Jamilyn Louise Desanti, MSW, LSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 11447 2nd St Ste 9b, Roscoe, IL 61073 Phone: 815-601-4673 Fax: 866-303-8062 | |
Sreeka Bharani, CRC, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 11447 2nd St, Roscoe, IL 61073 Phone: 815-623-2020 | |
Regino Isidro Sta Cruz Jr., Counselor Medicare: Not Enrolled in Medicare Practice Location: 5290 Williams Dr, Roscoe, IL 61073 Phone: 815-324-0324 | |
Mrs. Allison Diane Braswell, MSW, LCSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 4675 Bluestem Rd, Roscoe, IL 61073 Phone: 815-978-1067 Fax: 779-537-4555 |