| Acorn Counseling & Mediation, Ltd | |
|
101 Mccausland St Carlinville IL 62626-9133 | |
| (217) 930-2106 | |
| (217) 716-2265 |
| Full Name | Acorn Counseling & Mediation, Ltd |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 101 Mccausland St, Carlinville, Illinois |
| Authorized Official Name and Position | Wayne Spicer (REGISTERED AGENT) |
| Authorized Official Contact | 2178011242 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Acorn Counseling & Mediation, Ltd 9 Crestwood Dr Carlinville IL 62626-1847 Ph: (217) 930-2106 | Acorn Counseling & Mediation, Ltd 101 Mccausland St Carlinville IL 62626-9133 Ph: (217) 930-2106 |
| NPI Number | 1225490915 |
|---|---|
| Provider Enumeration Date | 03/22/2016 |
| Last Update Date | 05/04/2023 |
| Certification Date | 05/04/2023 |
| Medicare PECOS PAC ID | 6608127535 |
|---|---|
| Medicare Enrollment ID | O20180917000539 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225490915 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 149.018235 (Illinois) | Secondary |
| 251S00000X | Community/behavioral Health | 149.016405 (Illinois) | Primary |
| Provider Name | Andrea L Spicer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083091615 PECOS PAC ID: 4587975503 Enrollment ID: I20150617002345 |
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