| Sherry Brendalen, LPC | |
|
920 W Custer Ave, Pontiac, IL 61764-1067 | |
| (815) 844-6109 | |
| (815) 844-3561 |
| Full Name | Sherry Brendalen |
|---|---|
| Gender | Female |
| Speciality | Counselor - Mental Health |
| Location | 920 W Custer Ave, Pontiac, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518162676 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 180-006484 (Illinois) | Primary |
| Entity Name | Carle West Physician Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467074138 PECOS PAC ID: 8921420308 Enrollment ID: O20200613000147 |
| Mailing Address | Practice Location Address |
|---|---|
| Sherry Brendalen, LPC Po Box 768, Pontiac, IL 61764-0768 Ph: () - | Sherry Brendalen, LPC 920 W Custer Ave, Pontiac, IL 61764-1067 Ph: (815) 844-6109 |
Lauren Whitecotton, BA Counselor Medicare: Not Enrolled in Medicare Practice Location: 920 W Custer Ave, Pontiac, IL 61764 Phone: 815-844-6109 | |
Brittany Henson, MHP Counselor Medicare: Not Enrolled in Medicare Practice Location: 920 W Custer Ave, Pontiac, IL 61764 Phone: 815-844-6109 Fax: 815-844-3561 | |
Tiffany Meints, Counselor Medicare: Not Enrolled in Medicare Practice Location: 310 E Torrance Ave, Pontiac, IL 61764 Phone: 815-844-6109 Fax: 815-844-3561 | |
Sandra Boeckmann, LSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 920 W Custer Ave, Pontiac, IL 61764 Phone: 815-844-6109 Fax: 815-844-3561 | |
Meredith M Spraggon, MHP Counselor Medicare: Not Enrolled in Medicare Practice Location: 920 W Custer Ave, Pontiac, IL 61764 Phone: 815-844-6109 Fax: 815-844-3561 | |
Katie Kennedy, Counselor Medicare: Not Enrolled in Medicare Practice Location: 920 W Custer Ave, Pontiac, IL 61764 Phone: 815-844-6109 Fax: 815-844-3561 | |
Rhonda Looney, HS Counselor Medicare: Not Enrolled in Medicare Practice Location: 920 W Custer Ave, Pontiac, IL 61764 Phone: 815-844-6109 Fax: 815-844-3561 |