| Centennial Counseling Center, Pc | |
|
1120 E Main St Ste. 201 St Charles IL 60174-2287 | |
| (630) 377-6613 | |
| (630) 377-6225 |
| Full Name | Centennial Counseling Center, Pc |
|---|---|
| Speciality | Counselor |
| Location | 1120 E Main St, St Charles, Illinois |
| Authorized Official Name and Position | Timothy R Buhrt (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6303776613 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Centennial Counseling Center, Pc 1120 E Main St Ste. 201 St Charles IL 60174-2287 Ph: (630) 377-6613 | Centennial Counseling Center, Pc 1120 E Main St Ste. 201 St Charles IL 60174-2287 Ph: (630) 377-6613 |
| NPI Number | 1376544387 |
|---|---|
| Provider Enumeration Date | 08/02/2005 |
| Last Update Date | 02/14/2023 |
| Certification Date | 02/14/2023 |
| Medicare PECOS PAC ID | 7416959390 |
|---|---|
| Medicare Enrollment ID | O20070206000185 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376544387 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 060-007517 (Illinois) | Primary |
| Provider Name | Timothy R Buhrt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063408250 PECOS PAC ID: 4385646272 Enrollment ID: I20070206000226 |
| Provider Name | Jennifer L Mckay |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649207945 PECOS PAC ID: 4880871904 Enrollment ID: I20110526000676 |
| Provider Name | Jessica L Novak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811178262 PECOS PAC ID: 6002069390 Enrollment ID: I20130117000471 |
| Provider Name | Beverlee A Ludema |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750631560 PECOS PAC ID: 9830328830 Enrollment ID: I20140218000532 |
| Provider Name | Tina M Cooper |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811362676 PECOS PAC ID: 9436451663 Enrollment ID: I20170124002422 |
| Provider Name | Steven H Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740717834 PECOS PAC ID: 9436418068 Enrollment ID: I20180105000329 |
| Provider Name | Tiffany R Markelz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508355215 PECOS PAC ID: 8628322138 Enrollment ID: I20181120002498 |
| Provider Name | Jennifer Erin Geltz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366939266 PECOS PAC ID: 8426399536 Enrollment ID: I20190417001806 |
| Provider Name | Taryn M Colarusso |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396292439 PECOS PAC ID: 4385032473 Enrollment ID: I20211021002658 |
| Provider Name | Lindsey Nicole Fae Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881217123 PECOS PAC ID: 8527436716 Enrollment ID: I20221118001728 |
| Provider Name | Colin Nobis Eggleson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1740812569 PECOS PAC ID: 5991157380 Enrollment ID: I20240122002917 |
| Provider Name | Debra Lynn Ernst |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437462546 PECOS PAC ID: 5496107765 Enrollment ID: I20240123001112 |
| Provider Name | Mary Catherine (kay) Clarke |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114077567 PECOS PAC ID: 1557713849 Enrollment ID: I20240123001873 |
| Provider Name | John David Deku |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083004055 PECOS PAC ID: 1456703602 Enrollment ID: I20240123004242 |
| Provider Name | Scott M Gleeson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770201287 PECOS PAC ID: 4688026834 Enrollment ID: I20240123004455 |
| Provider Name | Krista Marie Mcdunn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922694256 PECOS PAC ID: 8123470382 Enrollment ID: I20240123004508 |
| Provider Name | Kyle James Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023350154 PECOS PAC ID: 8729431929 Enrollment ID: I20240124000999 |
| Provider Name | David J. Norton |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1033117361 PECOS PAC ID: 1850393737 Enrollment ID: I20240124001553 |
| Provider Name | Marko Tunjic |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1497215396 PECOS PAC ID: 7517310733 Enrollment ID: I20240124001798 |
| Provider Name | Sarah Elizabeth Carroll Turner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841713997 PECOS PAC ID: 6305299546 Enrollment ID: I20240124002350 |
| Provider Name | Ingo Weigold |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174124747 PECOS PAC ID: 1951754191 Enrollment ID: I20240124002678 |
| Provider Name | Cameron Keith Young |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1477071736 PECOS PAC ID: 9234582313 Enrollment ID: I20240124004120 |
| Provider Name | Laurie Ann Cox |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932227303 PECOS PAC ID: 0749623379 Enrollment ID: I20240209003218 |
| Provider Name | Amy Jo Heiman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912907932 PECOS PAC ID: 4082057625 Enrollment ID: I20240209003351 |
| Provider Name | Bernadette Marie Collins |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1134751969 PECOS PAC ID: 5294179370 Enrollment ID: I20240216001042 |
| Provider Name | Eileen C Sullivan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174045827 PECOS PAC ID: 0042742538 Enrollment ID: I20241022004065 |
| Provider Name | Kathryn A Buhrt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821816687 PECOS PAC ID: 7911432802 Enrollment ID: I20241202002595 |
| Provider Name | Janna Rose Matthis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821526245 PECOS PAC ID: 2466982210 Enrollment ID: I20250207002568 |
| Provider Name | Victor Robert Epperson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528638640 PECOS PAC ID: 8628596293 Enrollment ID: I20250516002903 |
| Provider Name | Christina Marie Cortes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356926497 PECOS PAC ID: 2365961802 Enrollment ID: I20250528001153 |
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