| Logan Health & Healing Center, Inc | |
|
1740 S Bell School Rd Ste B Cherry Valley IL 61016-9388 | |
| (815) 316-2621 | |
| (800) 493-9260 |
| Full Name | Logan Health & Healing Center, Inc |
|---|---|
| Speciality | Social Worker |
| Location | 1740 S Bell School Rd Ste B, Cherry Valley, Illinois |
| Authorized Official Name and Position | Julie Ann Logan (OWNER/PRACTITIONER) |
| Authorized Official Contact | 8153162621 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Logan Health & Healing Center, Inc 1740 S Bell School Rd Ste B Cherry Valley IL 61016-9388 Ph: (815) 316-2621 | Logan Health & Healing Center, Inc 1740 S Bell School Rd Ste B Cherry Valley IL 61016-9388 Ph: (815) 316-2621 |
| NPI Number | 1184090847 |
|---|---|
| Provider Enumeration Date | 08/18/2015 |
| Last Update Date | 07/20/2022 |
| Certification Date | 07/19/2022 |
| Medicare PECOS PAC ID | 3476963901 |
|---|---|
| Medicare Enrollment ID | O20201111002501 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184090847 | NPI | - | NPPES |
| 1184090847 | Other | IL | LOGAN HEALTH AND HEALING CENTER INC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Julie Ann Logan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700058005 PECOS PAC ID: 3577584937 Enrollment ID: I20051213000471 |
Julie Logan Counseling, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1740 S Bell School Rd Ste B, Cherry Valley, IL 61016 Phone: 815-316-2621 Fax: 800-493-9260 |