| Stephanie Lynn Provis, | |
|
34 W Grand Ave Ste 101, Fox Lake, IL 60020-1224 | |
| (847) 322-2975 | |
| Not Available |
| Full Name | Stephanie Lynn Provis |
|---|---|
| Gender | Female |
| Speciality | Mental Health Counselor |
| Experience | 1 Years |
| Location | 34 W Grand Ave Ste 101, Fox Lake, Illinois |
| Accepts Medicare Assignments | May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114711165 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (Illinois) | Primary |
| Entity Name | Bailey Behavioral Health LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790258408 PECOS PAC ID: 0547681058 Enrollment ID: O20200608002967 |
| Mailing Address | Practice Location Address |
|---|---|
| Stephanie Lynn Provis, 1307 W Lincoln Hwy Apt 3107, Dekalb, IL 60115-2932 Ph: (815) 901-7781 | Stephanie Lynn Provis, 34 W Grand Ave Ste 101, Fox Lake, IL 60020-1224 Ph: (847) 322-2975 |
Amber Nicole Shrum, LSW, CADC Counselor Medicare: May Accept Medicare Assignments Practice Location: 34 W Grand Ave Unit 101, Fox Lake, IL 60020 Phone: 847-322-2975 |
Diane M Bailey Yoder, LPC Counselor Medicare: May Accept Medicare Assignments Practice Location: 34 W Grand Ave Ste 101, Fox Lake, IL 60020 Phone: 847-322-2975 Fax: 888-436-1636 |
Elzbieta Wojnarowska, Counselor Medicare: May Accept Medicare Assignments Practice Location: 34 W Grand Ave Ste 101, Fox Lake, IL 60020 Phone: 847-322-2975 |
Mr. Joshua Tyler Armstrong, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 34 W Grand Ave Ste 101, Fox Lake, IL 60020 Phone: 815-762-7882 |
Taylor Kaether, MS, LCPC Counselor Medicare: Medicare Enrolled Practice Location: 34 W Grand Ave Ste 101, Fox Lake, IL 60020 Phone: 847-322-2975 |
Kellen M Smith, Counselor Medicare: Not Enrolled in Medicare Practice Location: 94 Eagle Point Rd, Fox Lake, IL 60020 Phone: 815-528-8965 |
Ms. Holly Kathleen Buchanan, NCC, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 34 W Grand Ave Ste 101, Fox Lake, IL 60020 Phone: 847-322-2975 |