| Champaign Counseling Llc | |
|
313 N Mattis Ave Ste 209 C/o Erik Olson Champaign IL 61821-2461 | |
| (217) 203-2008 | |
| Not Available |
| Full Name | Champaign Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 313 N Mattis Ave Ste 209, Champaign, Illinois |
| Authorized Official Name and Position | Sarah Olson (PRESIDENT) |
| Authorized Official Contact | 2177141322 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Champaign Counseling Llc Po Box 100 C/o: Erik Olson Savoy IL 61874-0100 Ph: (217) 390-6671 | Champaign Counseling Llc 313 N Mattis Ave Ste 209 C/o Erik Olson Champaign IL 61821-2461 Ph: (217) 203-2008 |
| NPI Number | 1770938359 |
|---|---|
| Provider Enumeration Date | 05/02/2016 |
| Last Update Date | 12/12/2016 |
| Medicare PECOS PAC ID | 9335429232 |
|---|---|
| Medicare Enrollment ID | O20161212001745 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770938359 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Tara C Beckett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952654584 PECOS PAC ID: 3971826587 Enrollment ID: I20150106000371 |
| Provider Name | Kimberly K Greenlee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679921837 PECOS PAC ID: 5496046112 Enrollment ID: I20160627002078 |
| Provider Name | Emily Lauren Beck |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598215212 PECOS PAC ID: 7416298732 Enrollment ID: I20190412001839 |
| Provider Name | Matthew Kenneth Rogers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922606235 PECOS PAC ID: 5294145223 Enrollment ID: I20201103002155 |
| Provider Name | Dana Lynn Baker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508300740 PECOS PAC ID: 3476905720 Enrollment ID: I20240123000503 |
| Provider Name | Michelle Hooks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356122808 PECOS PAC ID: 4284086588 Enrollment ID: I20240123002219 |
| Provider Name | Kye Thomas Ewing |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255071213 PECOS PAC ID: 9638521826 Enrollment ID: I20240124000656 |
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