| Braden Counseling Center, P.c. | |
|
2600 Dekalb Avenue Suite I Sycamore IL 60178 | |
| (815) 787-9000 | |
| (815) 787-9015 |
| Full Name | Braden Counseling Center, P.c. |
|---|---|
| Speciality | Behavior Analyst |
| Location | 2600 Dekalb Avenue, Sycamore, Illinois |
| Authorized Official Name and Position | Jayne A. Braden (PRESIDENT) |
| Authorized Official Contact | 8157879000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Braden Counseling Center, P.c. 2600 Dekalb Avenue Suite I Sycamore IL 60178 Ph: (815) 787-9000 | Braden Counseling Center, P.c. 2600 Dekalb Avenue Suite I Sycamore IL 60178 Ph: (815) 787-9000 |
| NPI Number | 1518026434 |
|---|---|
| Provider Enumeration Date | 12/06/2006 |
| Last Update Date | 06/18/2013 |
| Medicare PECOS PAC ID | 4981706348 |
|---|---|
| Medicare Enrollment ID | O20070305000034 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518026434 | NPI | - | NPPES |
| 01932029 | Other | IL | BLUECROSSBLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | A74100001A (Illinois) | Secondary |
| 103K00000X | Behavior Analyst | A74100001A (Illinois) | Primary |
| Provider Name | Jayne A Braden |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1548301443 PECOS PAC ID: 9436251899 Enrollment ID: I20070305000043 |
| Provider Name | Jane A Gaitskill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669625992 PECOS PAC ID: 7315169117 Enrollment ID: I20141111002140 |
| Provider Name | Brandie M Stiles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285913129 PECOS PAC ID: 4284861790 Enrollment ID: I20210510001176 |
| Provider Name | Victoria M Peyton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831761261 PECOS PAC ID: 8426445396 Enrollment ID: I20220422001219 |
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