| Bmsc Nc Llc | |
|
10204 Bode St Ste B Plainfield IL 60585-9813 | |
| (855) 241-7160 | |
| (954) 324-8354 |
| Full Name | Bmsc Nc Llc |
|---|---|
| Speciality | Social Worker |
| Location | 10204 Bode St Ste B, Plainfield, Illinois |
| Authorized Official Name and Position | Melanie Donohue (OWNER) |
| Authorized Official Contact | 8552417160 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bmsc Nc Llc 10204 Bode St Ste B Plainfield IL 60585-9813 Ph: (855) 241-7160 | Bmsc Nc Llc 10204 Bode St Ste B Plainfield IL 60585-9813 Ph: (855) 241-7160 |
| NPI Number | 1831611649 |
|---|---|
| Provider Enumeration Date | 07/13/2017 |
| Last Update Date | 05/18/2021 |
| Certification Date | 05/18/2021 |
| Medicare PECOS PAC ID | 9739445552 |
|---|---|
| Medicare Enrollment ID | O20171113000126 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831611649 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Lillie Marie Jacobs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750332540 PECOS PAC ID: 6103801295 Enrollment ID: I20040622001502 |
| Provider Name | Helen Kafer Varnadoe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205847324 PECOS PAC ID: 6305949017 Enrollment ID: I20070319000430 |
| Provider Name | Nina Kaye Hightower |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073843983 PECOS PAC ID: 2163554205 Enrollment ID: I20100724000315 |
| Provider Name | Delores Estelle Burrill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750532461 PECOS PAC ID: 6204127087 Enrollment ID: I20160627000259 |
| Provider Name | Irene F Reville |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932389442 PECOS PAC ID: 3072693894 Enrollment ID: I20180109001811 |
| Provider Name | Shelvey J Wallace |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588900989 PECOS PAC ID: 1153682604 Enrollment ID: I20180227000015 |
| Provider Name | Carolyn Whitlock Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144631805 PECOS PAC ID: 7618230012 Enrollment ID: I20180418000537 |
| Provider Name | Anita L Morrow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447605266 PECOS PAC ID: 4880941905 Enrollment ID: I20180720001399 |
| Provider Name | Carol Farmer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831429497 PECOS PAC ID: 7517211253 Enrollment ID: I20181114003562 |
| Provider Name | Alicia Richardson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760704274 PECOS PAC ID: 5799026498 Enrollment ID: I20190405002180 |
| Provider Name | Nicole Atkinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649684044 PECOS PAC ID: 6002240587 Enrollment ID: I20191217001841 |
| Provider Name | Victoria Wasulko |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518505239 PECOS PAC ID: 7719312743 Enrollment ID: I20200121000138 |
| Provider Name | Courtney N Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043724156 PECOS PAC ID: 4688000524 Enrollment ID: I20200212001758 |
| Provider Name | Michelle Lynn Ugolini |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841413358 PECOS PAC ID: 9537358494 Enrollment ID: I20200407001598 |
| Provider Name | Catherine J. Hall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134723588 PECOS PAC ID: 9830598937 Enrollment ID: I20210521001235 |
| Provider Name | Courtney Tierra Keith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770093452 PECOS PAC ID: 6901201607 Enrollment ID: I20210818002205 |
| Provider Name | Tiffany Summers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679132633 PECOS PAC ID: 8628469509 Enrollment ID: I20220104000881 |
| Provider Name | Renee Tong |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811494347 PECOS PAC ID: 7911259759 Enrollment ID: I20220526002585 |
| Provider Name | Catherine Sparks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851027650 PECOS PAC ID: 0345600995 Enrollment ID: I20230714001959 |
| Provider Name | Michelle Tompkins Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942770847 PECOS PAC ID: 7719309673 Enrollment ID: I20230817003183 |
| Provider Name | Betty Ann Simpson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881624559 PECOS PAC ID: 1951401041 Enrollment ID: I20231204003558 |
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