| Imagine More Counseling Solutions Llc | |
|
5906 Elaine Dr Ste 109 Rockford IL 61108-2467 | |
| (779) 212-4721 | |
| Not Available |
| Full Name | Imagine More Counseling Solutions Llc |
|---|---|
| Speciality | Counselor |
| Location | 5906 Elaine Dr Ste 109, Rockford, Illinois |
| Authorized Official Name and Position | Eric Jon Tanner (OWNER/THERAPIST) |
| Authorized Official Contact | 7792124721 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Imagine More Counseling Solutions Llc 7431 E State St Ste 354 Rockford IL 61108-2678 Ph: (779) 212-4721 | Imagine More Counseling Solutions Llc 5906 Elaine Dr Ste 109 Rockford IL 61108-2467 Ph: (779) 212-4721 |
| NPI Number | 1598346561 |
|---|---|
| Provider Enumeration Date | 04/20/2021 |
| Last Update Date | 04/21/2025 |
| Certification Date | 04/21/2025 |
| Medicare PECOS PAC ID | 3072048131 |
|---|---|
| Medicare Enrollment ID | O20241126001877 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598346561 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Eric Jon Tanner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689269003 PECOS PAC ID: 4981139045 Enrollment ID: I20241126002107 |
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