| Genesis Counseling Llc | |
|
208 S 1st Ave Morton IL 61550-2037 | |
| (309) 258-5713 | |
| Not Available |
| Full Name | Genesis Counseling Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 208 S 1st Ave, Morton, Illinois |
| Authorized Official Name and Position | Emma Kathryn Bucher (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 3092585713 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Counseling Llc 309 W Birchwood St Morton IL 61550-2405 Ph: (309) 258-5713 | Genesis Counseling Llc 208 S 1st Ave Morton IL 61550-2037 Ph: (309) 258-5713 |
| NPI Number | 1477184356 |
|---|---|
| Provider Enumeration Date | 01/30/2020 |
| Last Update Date | 01/30/2020 |
| Certification Date | 01/30/2020 |
| Medicare PECOS PAC ID | 5193154342 |
|---|---|
| Medicare Enrollment ID | O20201002001765 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477184356 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Emma K Bucher |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619523479 PECOS PAC ID: 1850623802 Enrollment ID: I20191024002262 |
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