| East Aurora Counseling Ltd | |
|
2755 Church Rd Aurora IL 60502-9745 | |
| (630) 486-3800 | |
| Not Available |
| Full Name | East Aurora Counseling Ltd |
|---|---|
| Speciality | Counselor |
| Location | 2755 Church Rd, Aurora, Illinois |
| Authorized Official Name and Position | Amanda Aller Goldman (OWNER) |
| Authorized Official Contact | 6304863800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| East Aurora Counseling Ltd 2755 Church Rd Aurora IL 60502-9745 Ph: (630) 486-3800 | East Aurora Counseling Ltd 2755 Church Rd Aurora IL 60502-9745 Ph: (630) 486-3800 |
| NPI Number | 1598277147 |
|---|---|
| Provider Enumeration Date | 11/03/2017 |
| Last Update Date | 12/27/2024 |
| Certification Date | 12/27/2024 |
| Medicare PECOS PAC ID | 6305367392 |
|---|---|
| Medicare Enrollment ID | O20250306001909 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598277147 | NPI | - | NPPES |
| 312961335001 | Medicaid | IL | |
| 1205352192 | Other | IL | CAQH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Patrick Thomas Noonan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205352192 PECOS PAC ID: 6204279367 Enrollment ID: I20240206003553 |
| Provider Name | Amanda Goldman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811090343 PECOS PAC ID: 8123499712 Enrollment ID: I20250421001957 |
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