| Noel Cordova, CADC, LPC | |
|
4419 W North Ave, Melrose Park, IL 60160-1021 | |
| (773) 777-7112 | |
| Not Available |
| Full Name | Noel Cordova |
|---|---|
| Gender | Male |
| Speciality | Counselor - Professional |
| Location | 4419 W North Ave, Melrose Park, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144685082 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 32131 (Illinois) | Secondary |
| 101YP2500X | Counselor - Professional | 178.011077 (Illinois) | Primary |
| Entity Name | Shift Counseling, P.c. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1619480019 PECOS PAC ID: 7113360256 Enrollment ID: O20240206002712 |
| Mailing Address | Practice Location Address |
|---|---|
| Noel Cordova, CADC, LPC 4419 W North Ave, Melrose Park, IL 60160-1021 Ph: (773) 777-7112 | Noel Cordova, CADC, LPC 4419 W North Ave, Melrose Park, IL 60160-1021 Ph: (773) 777-7112 |
Mr. Jason Peter Schallack, MFA Counselor Medicare: Not Enrolled in Medicare Practice Location: 1414 Main St, Melrose Park, IL 60160 Phone: 708-681-0073 Fax: 708-681-3958 | |
Richard O Sodeinde, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1414 Main St, Melrose Park, IL 60160 Phone: 708-681-0073 Fax: 708-681-3958 | |
Joanna Giordano, MA, LPC, QMHP Counselor Medicare: Medicare Enrolled Practice Location: 1414 Main St, Melrose Park, IL 60160 Phone: 708-681-0073 | |
Michelle Lagrimas, B.A. Counselor Medicare: Not Enrolled in Medicare Practice Location: 1414 Main St, Melrose Park, IL 60160 Phone: 708-681-4357 | |
Douglas William Barge, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1414 Main St, Melrose Park, IL 60160 Phone: 708-786-8546 | |
Natalie Jinete, Counselor Medicare: Medicare Enrolled Practice Location: 1414 Main St, Melrose Park, IL 60160 Phone: 708-681-0073 Fax: 708-681-3958 | |
Ms. Agnieszka Alina Wysocka, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4419 W North Ave, Melrose Park, IL 60160 Phone: 773-777-7112 Fax: 708-547-7732 |