| Counseling Clinic Ltd. | |
|
871 S Arbor Vitae Ste 3 Edwardsville IL 62025-3400 | |
| (618) 659-9111 | |
| (618) 692-9111 |
| Full Name | Counseling Clinic Ltd. |
|---|---|
| Speciality | Social Worker |
| Location | 871 S Arbor Vitae Ste 3, Edwardsville, Illinois |
| Authorized Official Name and Position | Jean Perry (OFFICE MANAGER) |
| Authorized Official Contact | 6186599111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Counseling Clinic Ltd. 871 S Arbor Vitae Suite 003 Edwardsville IL 62025-3400 Ph: (618) 659-9111 | Counseling Clinic Ltd. 871 S Arbor Vitae Ste 3 Edwardsville IL 62025-3400 Ph: (618) 659-9111 |
| NPI Number | 1922287887 |
|---|---|
| Provider Enumeration Date | 10/29/2007 |
| Last Update Date | 12/20/2021 |
| Certification Date | 12/20/2021 |
| Medicare PECOS PAC ID | 8820185374 |
|---|---|
| Medicare Enrollment ID | O20071030000529 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922287887 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Ruth C Kubicek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922155886 PECOS PAC ID: 4385731835 Enrollment ID: I20071030000519 |
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